Provider Demographics
NPI:1548271232
Name:STRATIGOS, JOHN (PT)
Entity type:Individual
Prefix:PROF
First Name:JOHN
Middle Name:
Last Name:STRATIGOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6061 N 1ST ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5470
Mailing Address - Country:US
Mailing Address - Phone:559-435-6905
Mailing Address - Fax:
Practice Address - Street 1:6061 N 1ST ST
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5470
Practice Address - Country:US
Practice Address - Phone:559-435-6905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00379132OtherRAILROAD MEDICARE
CAZZZ04216ZMedicare PIN
CAOPT179171Medicare PIN