Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | X006139 | NY |
NPI | 1477693240 |
---|---|
Provider Name | Dr. Christos Vasakiris |
First Address | Lindenhurst, NY 11757-5630 |
Second Address | Lindenhurst, NY 11757-5630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 02/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
X43901 | (02) | NY |