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General NPI Number Information
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NPI Number | 1831820026
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Entity Type | Organization
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Legal Business Name | DR. PAUL POULAKOS DO, PLLC
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 412 6TH AVE FL 7
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City | NEW YORK
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State | NY
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Zip | 10011-8409
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Country | US
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Telephone | 850-692-9355
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Fax | 833-337-2089
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Provider Business Mailing Address
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Address Line | 412 6TH AVE FL 7
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City | NEW YORK
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State | NY
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Zip | 10011-8409
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Country | US
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Telephone | 850-692-9355
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Fax | 833-337-2089
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PAUL POULAKOS
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Credential | DO
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Telephone | 850-692-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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