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Individual

DR. THOMAS SCANDALIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
NORTHERN BLVD, ACADEMIC HEALTH CARE CENTER NY INSTITUTE OF TECHNOLOGY, OLD WESTBURY, NY 11568-8000
(516) 686-3751
(516) 686-7890
Mailing address
NORTHERN BLVD, ACADEMIC HEALTH CARE CENTER NY INSTITUTE OF TECHNOLOGY, OLD WESTBURY, NY 11568-8000
(516) 686-3751
(516) 686-7890

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
175161
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1750370037
NPI NUMBER
NY
01
1821048612
GROUP NPI NUMBER
NY
Enumeration date
10/19/2005
Last updated
06/30/2008
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