Provider Demographics
NPI:1871830869
Name:SARANTAKOS, LOUIS (OD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:SARANTAKOS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7402
Mailing Address - Country:US
Mailing Address - Phone:212-242-0314
Mailing Address - Fax:212-242-0385
Practice Address - Street 1:9 W 14TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7402
Practice Address - Country:US
Practice Address - Phone:212-242-0314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004938152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist