Provider Demographics
NPI:1710618798
Name:VASILIOS KOUNTIS DO, PLLC
Entity Type:Organization
Organization Name:VASILIOS KOUNTIS DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VASILIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUNTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-235-1265
Mailing Address - Street 1:78 TODT HILL RD STE 112
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4528
Mailing Address - Country:US
Mailing Address - Phone:718-962-7246
Mailing Address - Fax:800-615-2463
Practice Address - Street 1:78 TODT HILL RD STE 112
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4528
Practice Address - Country:US
Practice Address - Phone:718-962-7246
Practice Address - Fax:800-615-2463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies