Provider Demographics
NPI:1255495651
Name:POULAKI, VASILIKI (MD)
Entity Type:Individual
Prefix:DR
First Name:VASILIKI
Middle Name:
Last Name:POULAKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2005 BAY ST STE 206
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-1085
Mailing Address - Country:US
Mailing Address - Phone:508-823-7473
Mailing Address - Fax:508-824-3830
Practice Address - Street 1:850 HARRISON AVE # ACC-3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4001
Practice Address - Country:US
Practice Address - Phone:617-414-4020
Practice Address - Fax:617-414-4028
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA231460207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist