Healthcare Provider Details

I. General information

NPI: 1467703546
Provider Name (Legal Business Name): PANAGIOTIS KAKATSOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 FIRST AVENUE METROPLOITAN HOSPITAL CENTER ROOM 4M3
NEW YORK NY
10029
US

IV. Provider business mailing address

1901 1ST AVE METROPOLITAN HOSPITAL RM 4M3
NEW YORK NY
10029-7404
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-6262
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: