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Contact Information

THEOFANIS MITSINIKOS, DO
2500 NESCONSET HWY
BLDG 3C
STONY BROOK, NY11790-2555
 Phone: 631-751-2400
 Fax: 631-751-8323
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endocrinology, Diabetes & Metabolism

207RE0101X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for THEOFANIS MITSINIKOS · (Male)

NPI Number 1467624064
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/24/2008
Last updated 01/13/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 235458
Hospital affiliation(s)
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY ROAD
    PORT JEFFERSON, NY 11777
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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