| NPI | 1548560527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMOS G KANAKOUDAS Owner/Medical Director 631-751-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 257261) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 010895) |
| 111NS0005X Chiropractor, Sports Physician | |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2021-03-14 |