Provider Demographics
NPI:1942683610
Name:SAPOUNTZIS, IONAS (PHD)
Entity Type:Individual
Prefix:
First Name:IONAS
Middle Name:
Last Name:SAPOUNTZIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4524
Mailing Address - Country:US
Mailing Address - Phone:516-248-6740
Mailing Address - Fax:516-248-6788
Practice Address - Street 1:721 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4524
Practice Address - Country:US
Practice Address - Phone:516-248-6740
Practice Address - Fax:516-248-6788
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012603-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist