Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 247313 | NY |
N | 111NI0900X | Internist | 247313 | NY |
Y | 207RG0300X | Geriatric Medicine | 247313 | NY |
NPI | 1154597425 |
---|---|
Provider Name | Dr. Eirene Mamakos Milano |
First Address | Dix Hills, NY 11746-7725 |
Second Address | Woodbury, NY 11797-2946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2008 |
Last Update Date | 11/05/2010 |