Provider Demographics
NPI:1295024883
Name:KONTOS, SPYRIDON N (RD, CDN, CDE)
Entity Type:Individual
Prefix:MR
First Name:SPYRIDON
Middle Name:N
Last Name:KONTOS
Suffix:
Gender:M
Credentials:RD, CDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 CENTRAL PARK W
Mailing Address - Street 2:SUITE # 6E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4381
Mailing Address - Country:US
Mailing Address - Phone:212-865-0701
Mailing Address - Fax:212-865-0788
Practice Address - Street 1:425 CENTRAL PARK W
Practice Address - Street 2:SUITE # 6E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4381
Practice Address - Country:US
Practice Address - Phone:212-865-0701
Practice Address - Fax:212-865-0788
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006916133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered