Fandos, Luis M

Fandos, Luis M is an individual health care provider with primary practice located at 500 W Main St Suite 116, Babylon NY 11702. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Fandos, Luis M can be contacted via phone (631) 422-6166.

Contact Information

Primary practice address
500 W Main St Suite 116 Babylon NY 11702
Phone: (631) 422-6166
Fax: (631) 422-6266
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 208260 New York
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 208260 New York

Profile Details

NPI number 1376572594
LBN Legal business name Fandos, Luis M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2006
Last updated Jun 18th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376572594 NPPES
New York MEDICAID 01793255

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