Provider Demographics
NPI:1407942162
Name:GIANNAKOPOULOS, ANDRE GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:GEORGE
Last Name:GIANNAKOPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CYPRESS LN W.
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590
Mailing Address - Country:US
Mailing Address - Phone:516-833-6331
Mailing Address - Fax:516-333-5585
Practice Address - Street 1:2578 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2136
Practice Address - Country:US
Practice Address - Phone:516-333-5555
Practice Address - Fax:516-333-5585
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236820207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine