Provider Demographics
NPI:1801115423
Name:CONTOVASILIS, JESSE ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:ARTHUR
Last Name:CONTOVASILIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:755 PARK AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3975
Mailing Address - Country:US
Mailing Address - Phone:631-357-0006
Mailing Address - Fax:631-350-7232
Practice Address - Street 1:755 PARK AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3975
Practice Address - Country:US
Practice Address - Phone:631-357-0006
Practice Address - Fax:631-350-7232
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2014-06-26
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Provider Licenses
StateLicense IDTaxonomies
NY2732712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry