Individual
KONSTANTINOS SPANIOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HSC T19 020, STONY BROOK MEDICINE, STONY BROOK, NY 11794-8191
(631) 444-2274
(631) 444-6176
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
15643
NH
208600000X
Surgery Physician
2013-01267
NC
208600000X
Surgery Physician
Primary
286029
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477674562
—
NC
01
—
180Y2
BCBS NC
NC
Enumeration date
04/03/2007
Last updated
09/20/2016
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