Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 155527 | NY |
NPI | 1043281280 |
---|---|
Provider Name | Dr. Emanuel L Kouroupos |
First Address | Astoria, NY 11102 |
Second Address | Astoria, NY 11102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 18/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00869470 | (05) | NY |
A62323 | (02) | NY |