Organization
PROTHERA MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIKE PAPPAS MD (PHYSICIAN)
(631) 424-1240
Entity
Organization
Contact information
Practice address
1274 EAST MAIN STREET, RIVERHEAD, NY 11901
(631) 424-1240
(631) 424-1241
Mailing address
1274 EAST MAIN STREET, RIVERHEAD, NY 11901
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
222059
NY
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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