Provider Demographics
NPI:1851840714
Name:KEHAGIAS, VASILIOS (CPO)
Entity Type:Individual
Prefix:
First Name:VASILIOS
Middle Name:
Last Name:KEHAGIAS
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 ASTORIA BLVD
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-4345
Mailing Address - Country:US
Mailing Address - Phone:917-832-6454
Mailing Address - Fax:917-832-6640
Practice Address - Street 1:2305 ASTORIA BLVD
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-4345
Practice Address - Country:US
Practice Address - Phone:917-832-6454
Practice Address - Fax:917-832-6640
Is Sole Proprietor?:No
Enumeration Date:2016-10-03
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CPO03679222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist