Provider Demographics
NPI:1245215961
Name:KAKNIS, GEORGE JAMES (OD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JAMES
Last Name:KAKNIS
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 1:1073 MAIN STREET
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1792
Mailing Address - Country:US
Mailing Address - Phone:845-896-2017
Mailing Address - Fax:845-897-5702
Practice Address - Street 1:1073 MAIN ST
Practice Address - Street 2:SUITE 106
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-3513
Practice Address - Country:US
Practice Address - Phone:845-896-2017
Practice Address - Fax:845-897-5702
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004908-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY141769142OtherNYS EMPIRE PLAN
NY141769142OtherUNITED HEALTHCARE
NY497534OtherAETNA HMO
NYC49951OtherBCBS
NYP868482OtherOXFORD
NY0749460001OtherDMERC
NY10046614OtherCDPHP
NY141769142OtherMULTIPLAN
NY597001OtherMVP
NY497534OtherAETNA
NY10046614OtherCDPHP
NY141769142OtherUNITED HEALTHCARE