# PLATINUM PROVIDERS GROUP LLC

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

## Provider details

- **NPI number:** 1457080178
- **Authorized official:** ATHANASIOS G. PAPASTAMELOS DO (MANAGING MEMBER)
- **Authorized official phone:** (609) 469-1585

## Contact information

- **Practice address:** 1418 NEW RD STE 1, NORTHFIELD, NJ 08225-1179
- **Practice address phone:** (609) 796-7969
- **Practice address fax:** (609) 642-2663
- **Mailing address:** 2106 NEW RD STE F2, LINWOOD, NJ 08221-1053
- **Mailing address phone:** (609) 796-7969
- **Mailing address fax:** (609) 642-2663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/08/2022
- **Last updated:** 07/15/2026