Provider Demographics
NPI:1578759841
Name:C&K PREVENTIVE HEALTH
Entity Type:Organization
Organization Name:C&K PREVENTIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KONSTANTINOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARABATZIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-372-5722
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:
Mailing Address - City:ALLEGANY
Mailing Address - State:NY
Mailing Address - Zip Code:14706-0055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 SATELLITE CIR
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1628
Practice Address - Country:US
Practice Address - Phone:716-372-5722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health