National Provider Identifier Database

ANTHONY C THEODORIS, MD – NPI #1578675971
Pulmonary Disease

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.


Contact Information

ANTHONY C THEODORIS, MD
1500 ROUTE 112 STE B
PORT JEFFERSON STATION, NY11776-8054
Phone: 631-978-7633
Fax: 631-638-4884
Website:
Specialty Taxonomy Code
* Pulmonary Disease 207RP1001X

* Indicates primary specialty

NPI Profile & details for ANTHONY C THEODORIS

NPI Number 1578675971
Credentials MD
Entity Individual
Enumeration date 08/31/2006
Last updated 04/29/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • NY License #: 221756-1
  • NY Medicaid: 02732167
  • NY Other: 7V691EC831 MEDICARE OTHER PIN
Hospital affiliation n/a

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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