| Antonios Tsompanidis Do Pc | |
|
1 Bethany Rd Suite 79 Hazlet NJ 07730-1663 | |
| (732) 203-0800 | |
| (732) 203-9494 |
| Full Name | Antonios Tsompanidis Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Bethany Rd, Hazlet, New Jersey |
| Authorized Official Name and Position | Antonios Tsompanidis (OWNER) |
| Authorized Official Contact | 7322030800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Antonios Tsompanidis Do Pc 1 Bethany Rd Suite 79 Hazlet NJ 07730-1663 Ph: (732) 203-0800 | Antonios Tsompanidis Do Pc 1 Bethany Rd Suite 79 Hazlet NJ 07730-1663 Ph: (732) 203-0800 |
| NPI Number | 1619002490 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4688868813 |
|---|---|
| Medicare Enrollment ID | O20101102000658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619002490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MB06310800 (New Jersey) | Primary |
| Provider Name | Antonios J Tsompanidis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679646608 PECOS PAC ID: 9830383066 Enrollment ID: I20101102000795 |
| Provider Name | Dinamarie Perrino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932277332 PECOS PAC ID: 9931349438 Enrollment ID: I20130705000076 |
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