Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 045404-01 | NY |
Y | 225100000X | Physical Therapist | 045404 | NY |
NPI | 1346888922 |
---|---|
Provider Name | Dr. Joseph Matthew Artoglou |
First Address | Sag Harbor, NY 11963-3106 |
Second Address | Sag Harbor, NY 11963-3106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2019 |
Last Update Date | 09/07/2021 |