Provider Demographics
NPI:1245632728
Name:PAPANAGNOU, ANASTASIOS
Entity type:Individual
Prefix:DR
First Name:ANASTASIOS
Middle Name:
Last Name:PAPANAGNOU
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ANASTASIOS
Other - Middle Name:
Other - Last Name:PAPANAGNOU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:53 PEEKSKILL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-3252
Mailing Address - Country:US
Mailing Address - Phone:845-528-5700
Mailing Address - Fax:
Practice Address - Street 1:53 PEEKSKILL HOLLOW RD
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-3252
Practice Address - Country:US
Practice Address - Phone:845-528-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291768207RN0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist