Provider Demographics
NPI:1437410024
Name:KOUNTIS, VASILIOS (DO)
Entity Type:Individual
Prefix:DR
First Name:VASILIOS
Middle Name:
Last Name:KOUNTIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 3RD AVE FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2957
Mailing Address - Country:US
Mailing Address - Phone:212-235-1265
Mailing Address - Fax:800-615-2463
Practice Address - Street 1:1317 3RD AVE FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-235-1265
Practice Address - Fax:800-615-2463
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276937208VP0014X, 2081P2900X
NJ25MB09681700208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine