| NPI | 1770169468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE KAKOULIDES Owner 631-400-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-03-22 |