Individual
DR. STEFANOS PANTAGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
810 MAIN ST, HACKENSACK, NJ 07601-4847
(201) 633-7375
(201) 633-7361
Mailing address
164 WINTHROP PL, ENGLEWOOD, NJ 07631-3054
(201) 633-7375
(201) 633-7361
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MA64903
NJ
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
MA64903
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6818706
—
NJ
Enumeration date
10/24/2006
Last updated
02/05/2014
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