Organization
GERIATRICS AND LONGEVITY TREATMENT SPECIALIST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEFANOS G PANTAGIS MD (OWNER)
(201) 663-7375
Entity
Organization
Contact information
Practice address
810 MAIN ST, HACKENSACK, NJ 07601-4847
(201) 663-7375
Mailing address
810 MAIN ST, HACKENSACK, NJ 07601-4847
(201) 663-7375
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
10/19/2011
Last updated
11/13/2013
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