Organization
PLATINUM PROVIDERS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATHANASIOS G. PAPASTAMELOS DO (MANAGING MEMBER)
(609) 469-1585
Entity
Organization
Contact information
Practice address
1418 NEW RD STE 1, NORTHFIELD, NJ 08225-1179
(609) 796-7969
(609) 642-2663
Mailing address
2106 NEW RD STE F2, LINWOOD, NJ 08221-1053
(609) 796-7969
(609) 642-2663
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
06/08/2022
Last updated
07/14/2025
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