NPI 1790191427

Action Medical PC

Organisation Sports Medicine (Family Medicine) Physician East Setauket, NY

Practice location

Address: 8 Technology Dr Suite 104, East Setauket, NY 11733-3327
Phone: (631) 689-8662
Fax: (631) 689-5916

Authorised official

Name: Dimos Kanakoudas
Title: President
Phone: (631) 689-8662

Registered specialties

Sports Medicine (Family Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QS0010X Licence 257261 (NY)

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Registry record

NPI: 1790191427
Entity type: Organization
NPI issued: 2 Jul 2014
Record last updated: 2 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.