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General NPI Number Information
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NPI Number | 1134145873
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Entity Type | Individual
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Provider Name | NICHOLAS FOTIOS KAROUTSOS DPM
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 22002 73RD AVE
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364-2624
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Country | US
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Telephone | 718-464-8870
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Fax | 718-464-8871
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Provider Business Mailing Address
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Address Line | 22002 73RD AVE
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City | BAYSIDE
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State | NY
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Zip | 11364-2624
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Country | US
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Telephone | 718-464-8870
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Fax | 718-464-8870
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N005842
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 25MD00271600
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License Number State | NJ
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