Individual provider · Type 1 NPI

Giorgi Mamardashvili, MD

Student in an Organized Health Care Education/Training Program · Stoney Brook, NY

NPI number 1669315669 Active

Practice location

101 Nicolls Road, HSCT11-40
Stoney Brook, NY 11794-8111

Call (631) 444-2020 Map

Fax (631) 444-2894

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

69 other providers at this address

About NPI 1669315669

Giorgi Mamardashvili, MD's National Provider Identifier is 1669315669, issued on Apr 13, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Stoney Brook, NY. The record was last updated on Oct 16, 2026.