Provider Demographics
NPI:1427601574
Name:BOURIS, VASILEIOS (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:VASILEIOS
Middle Name:
Last Name:BOURIS
Suffix:
Gender:M
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 E 84TH ST.
Mailing Address - Street 2:MANHATTAN
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:917-294-8563
Mailing Address - Fax:
Practice Address - Street 1:152 E 84TH ST.
Practice Address - Street 2:MANHATTAN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:917-294-8563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program