Healthcare Provider Details

I. General information

NPI: 1063272003
Provider Name (Legal Business Name): VASILEIOS NIKOLAOS PILILIS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 TEMPLE ST STE 1B
NEW HAVEN CT
06510-2715
US

IV. Provider business mailing address

8786 PERIMETER PARK BLVD
JACKSONVILLE FL
32216-6347
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number83642
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number83642
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: