Provider Demographics
NPI:1477693240
Name:VASAKIRIS, CHRISTOS (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOS
Middle Name:
Last Name:VASAKIRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 W MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-5630
Mailing Address - Country:US
Mailing Address - Phone:631-226-3030
Mailing Address - Fax:631-226-3811
Practice Address - Street 1:350 W MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-5630
Practice Address - Country:US
Practice Address - Phone:631-226-3030
Practice Address - Fax:631-226-3811
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006139111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX43901Medicare UPIN