Provider Demographics
NPI:1497806194
Name:BILITSIS, CHARALAMPOS (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARALAMPOS
Middle Name:
Last Name:BILITSIS
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 1:1015 DAHILL RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1741
Mailing Address - Country:US
Mailing Address - Phone:718-377-0083
Mailing Address - Fax:
Practice Address - Street 1:42 BROADWAY STE 1535
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-3885
Practice Address - Country:US
Practice Address - Phone:212-401-6923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor