Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | MT191836 | PA |
NPI | 1144487968 |
---|---|
Provider Name | Dr. Vasileios Kostaras |
First Address | Stony Brook, NY 11794-8191 |
Second Address | Stony Brook, NY 11794-8191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 21/08/2012 |