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General NPI Number Information
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NPI Number | 1407942162
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Entity Type | Individual
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Provider Name | ANDRE GEORGE GIANNAKOPOULOS M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 2578 HEMPSTEAD TPKE
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City | EAST MEADOW
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State | NY
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Zip | 11554-2136
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Country | US
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Telephone | 516-333-5555
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Fax | 516-333-5585
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Provider Business Mailing Address
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Address Line | 205 CYPRESS LN W.
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City | WESTBURY
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State | NY
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Zip | 11590
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Country | US
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Telephone | 516-833-6331
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Fax | 516-333-5585
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 236820
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License Number State | NY
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