Provider Demographics
NPI:1285462671
Name:HIPPOCRATES MEDICAL & SURGICAL CENTER LLC
Entity type:Organization
Organization Name:HIPPOCRATES MEDICAL & SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GIANNIKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-749-3027
Mailing Address - Street 1:2605 23RD AVENUE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105
Mailing Address - Country:US
Mailing Address - Phone:718-749-3027
Mailing Address - Fax:347-235-0302
Practice Address - Street 1:2605 23RD AVENUE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105
Practice Address - Country:US
Practice Address - Phone:718-749-3027
Practice Address - Fax:347-235-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00935084Medicaid