Individual
MARIOS DIMITRIOS GAGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-1277
(516) 437-4167
Mailing address
PO BOX 27842, NEW YORK, NY 10087-7842
(718) 670-1651
(516) 437-4167
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
250535
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03159437
—
NY
Enumeration date
07/20/2009
Last updated
01/24/2012
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