Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 3446 | PA |
NPI | 1194898312 |
---|---|
Provider Name | Mr. Angelo Karakasis |
First Address | Upper Darby, PA 19082-2303 |
Second Address | Upper Darby, PA 19082-2303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |