Individual
MR. DIMITRIOS S MASTROGIANNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD,PHD,FACOG
Contact information
Practice address
90 PRESIDENTIAL PLAZA, 3RD FL, SYRACUSE, NY 13202
(315) 464-4458
(315) 464-6388
Mailing address
251 SALINA MEADOWS PKWY, SUITE 100, SYRACUSE, NY 13212-4516
(315) 464-2000
(315) 464-2010
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
181866
NY
207VM0101X
Maternal & Fetal Medicine Physician
Primary
181866
NY
2080N0001X
Neonatal-Perinatal Medicine Physician
181866
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01464295
—
NY
05
—
036.136742
—
IL
Enumeration date
07/04/2006
Last updated
11/14/2019
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