Provider Demographics
NPI:1083864318
Name:KOUNTIS, HRISOULA MARIA (PA)
Entity Type:Individual
Prefix:MRS
First Name:HRISOULA
Middle Name:MARIA
Last Name:KOUNTIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 EAST 76TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-235-1265
Mailing Address - Fax:
Practice Address - Street 1:155 E 76TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2810
Practice Address - Country:US
Practice Address - Phone:212-235-1265
Practice Address - Fax:800-615-2463
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical