Provider Demographics
NPI:1649938564
Name:KATEHIS, VASILIOS
Entity type:Individual
Prefix:
First Name:VASILIOS
Middle Name:
Last Name:KATEHIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25502 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1101
Mailing Address - Country:US
Mailing Address - Phone:718-223-0918
Mailing Address - Fax:
Practice Address - Street 1:25502 73RD AVE
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1101
Practice Address - Country:US
Practice Address - Phone:718-223-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician