Provider Demographics
NPI:1750346045
Name:GIANNOUKOS, EPHIGENIA (MD)
Entity type:Individual
Prefix:DR
First Name:EPHIGENIA
Middle Name:
Last Name:GIANNOUKOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EPHIGENIA
Other - Middle Name:KOUMATOS
Other - Last Name:GIANNOUKOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:66 OMEGA DR BLDG E
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2061
Mailing Address - Country:US
Mailing Address - Phone:302-892-3300
Mailing Address - Fax:302-892-9824
Practice Address - Street 1:66 OMEGA DR BLDG E
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2061
Practice Address - Country:US
Practice Address - Phone:302-892-3300
Practice Address - Fax:302-892-9824
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003971208000000X
DEC1/00039712080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics