Provider Demographics
NPI:1356232292
Name:SPYRIDON KANTAS, MD, LLC
Entity type:Organization
Organization Name:SPYRIDON KANTAS, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SPYRIDON
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-886-3504
Mailing Address - Street 1:45 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-2547
Mailing Address - Country:US
Mailing Address - Phone:978-886-3504
Mailing Address - Fax:
Practice Address - Street 1:69 PARK ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3691
Practice Address - Country:US
Practice Address - Phone:978-886-3504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care