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General NPI Number Information
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NPI Number | 1699078741
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Entity Type | Organization
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Legal Business Name | KOSTAS A. KATSAVDAKIS, PHD, PC
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 276 5TH AVE SUITE 905
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City | NEW YORK
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State | NY
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Zip | 10001-4509
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Country | US
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Telephone | 212-571-4249
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Fax | 212-571-4176
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Provider Business Mailing Address
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Address Line | 276 5TH AVE SUITE 905
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City | NEW YORK
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State | NY
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Zip | 10001-4509
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Country | US
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Telephone | 212-571-4249
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Fax | 212-571-4176
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. KOSTAS ANDREAS KATSAVDAKIS
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Credential | PHD
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Telephone | 212-571-4249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0150181
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License Number State | NY
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