# ATHANASIOS ANTONIADIS OB GYN PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427232545
- **Authorized official:** ATHANASIOS ANTONIADIS OBGYN PC (PRESIDENT)
- **Authorized official phone:** (631) 376-1010

## Contact information

- **Practice address:** 750 MONTAUK HWY, WEST ISLIP, NY 11795-4411
- **Practice address phone:** (631) 376-1010
- **Practice address fax:** (631) 376-2156
- **Mailing address:** 750 MONTAUK HWY, WEST ISLIP, NY 11795-4411
- **Mailing address phone:** (631) 376-1010
- **Mailing address fax:** (631) 376-2156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/26/2007
- **Last updated:** 04/09/2014