Provider Demographics
NPI:1497789622
Name:ASTERS, DIMITRIOS (MD)
Entity type:Individual
Prefix:
First Name:DIMITRIOS
Middle Name:
Last Name:ASTERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2226
Mailing Address - Country:US
Mailing Address - Phone:718-728-2555
Mailing Address - Fax:
Practice Address - Street 1:4401 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-2226
Practice Address - Country:US
Practice Address - Phone:718-728-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220925207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02280573Medicaid
NYH69374Medicare UPIN
NY02280573Medicaid