Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 265932 | NY |
Y | 111NI0900X | Internist | 265932 | NY |
NPI | 1003115999 |
---|---|
Provider Name | Dr. Konstadinos J Spyris |
First Address | Islip, NY 11751-3703 |
Second Address | Southampton, NY 11968-5009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2011 |
Last Update Date | 23/03/2017 |