Provider Demographics
NPI:1639440712
Name:REKOUTIS, PANAGIOTIS (PHD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:PANAGIOTIS
Middle Name:
Last Name:REKOUTIS
Suffix:
Gender:M
Credentials:PHD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:683 DEGRAW ST
Mailing Address - Street 2:APT # 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3111
Mailing Address - Country:US
Mailing Address - Phone:718-230-3129
Mailing Address - Fax:
Practice Address - Street 1:683 DEGRAW ST
Practice Address - Street 2:APT # 3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3111
Practice Address - Country:US
Practice Address - Phone:718-230-3129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010084-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist