Provider Demographics
NPI:1154597425
Name:MILANO, EIRENE MAMAKOS (MD)
Entity type:Individual
Prefix:DR
First Name:EIRENE
Middle Name:MAMAKOS
Last Name:MILANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BALSAM DR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7725
Mailing Address - Country:US
Mailing Address - Phone:718-926-7383
Mailing Address - Fax:
Practice Address - Street 1:99 SUNNYSIDE BLVD
Practice Address - Street 2:C/O HOSPICE CARE NETWORK
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2946
Practice Address - Country:US
Practice Address - Phone:516-832-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247313207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG300000331Medicare PIN