Provider Demographics
NPI:1669906061
Name:VASILIOS KOUNTIS DO, PLLC
Entity type:Organization
Organization Name:VASILIOS KOUNTIS DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:VASILIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUNTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-235-1265
Mailing Address - Street 1:PO BOX 90406
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-0406
Mailing Address - Country:US
Mailing Address - Phone:212-235-1265
Mailing Address - Fax:800-615-2463
Practice Address - Street 1:1317 3RD AVE FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2957
Practice Address - Country:US
Practice Address - Phone:212-235-1265
Practice Address - Fax:800-615-2463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP3300X
NY2769372081P2900X, 2081P2900X
NY227259261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty