Provider Demographics
NPI:1952373110
Name:TRIANTOS, SPYRIDON (MD)
Entity Type:Individual
Prefix:
First Name:SPYRIDON
Middle Name:
Last Name:TRIANTOS
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:PO BOX 18612
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07191-8612
Mailing Address - Country:US
Mailing Address - Phone:413-443-6000
Mailing Address - Fax:413-442-2260
Practice Address - Street 1:8 CONTE DR
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-8298
Practice Address - Country:US
Practice Address - Phone:413-443-6000
Practice Address - Fax:413-442-2260
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204181207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH23896Medicare UPIN
MAA31527Medicare ID - Type Unspecified