Provider Demographics
NPI:1942205901
Name:PAPPAS, DEAN PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:PAUL
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 FRANKLIN AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-3221
Mailing Address - Country:US
Mailing Address - Phone:516-248-2422
Mailing Address - Fax:516-248-5162
Practice Address - Street 1:1100 FRANKLIN AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3221
Practice Address - Country:US
Practice Address - Phone:516-248-2422
Practice Address - Fax:516-248-5162
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205432-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9141819OtherPHCS
NY9610114OtherGHI
NYAA71795OtherMDNY
NY00000093438OtherBEECHSTREET
NY2819678OtherAETNA
NY7006141OtherAETNA MC & PPO
NY030438737OtherUNITED-EMPIRE PLAN
NY107177OtherVYTRA
NY2J3731OtherBC/BS
NY2085293OtherFIRST HEALTH
NYP2214630OtherOXFORD
NY33250-POtherHIP
NY4C1304OtherPHS
NY4C1304OtherPHS
NY7006141OtherAETNA MC & PPO