Provider Demographics
NPI:1295165553
Name:JAMES STALLONE, D.O.
Entity type:Organization
Organization Name:JAMES STALLONE, D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:STALLONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-321-4200
Mailing Address - Street 1:400 W MAIN ST
Mailing Address - Street 2:SUITE 234
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3012
Mailing Address - Country:US
Mailing Address - Phone:631-321-4200
Mailing Address - Fax:631-321-1594
Practice Address - Street 1:400 W MAIN ST
Practice Address - Street 2:SUITE 234
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3012
Practice Address - Country:US
Practice Address - Phone:631-321-4200
Practice Address - Fax:631-321-1594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0170968261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY38F231Medicare PIN