Provider Demographics
NPI:1659644466
Name:ALEXANDROS GIANNAKAKOS MD PC
Entity Type:Organization
Organization Name:ALEXANDROS GIANNAKAKOS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDROS
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANNAKAKOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-980-9828
Mailing Address - Street 1:192 GUYON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3943
Mailing Address - Country:US
Mailing Address - Phone:718-980-9828
Mailing Address - Fax:718-979-4291
Practice Address - Street 1:192 GUYON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3943
Practice Address - Country:US
Practice Address - Phone:718-980-9828
Practice Address - Fax:718-979-4291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty