Provider Demographics
NPI:1295729457
Name:PAPPAS, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 E 32ND ST
Mailing Address - Street 2:PH (14TH FLOOR)
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6055
Mailing Address - Country:US
Mailing Address - Phone:646-754-2222
Mailing Address - Fax:
Practice Address - Street 1:160 E 32ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6004
Practice Address - Country:US
Practice Address - Phone:646-754-2222
Practice Address - Fax:646-754-2250
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182592207SM0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SM0001XAllopathic & Osteopathic PhysiciansMedical GeneticsMolecular Genetic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01591331Medicaid
NY525621Medicare ID - Type Unspecified
NY01591331Medicaid