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General NPI Number Information
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NPI Number | 1982139077
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Entity Type | Individual
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Provider Name | NIKOLAOS MOUCHTOURIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 909 WALNUT ST 2ND FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5211
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Country | US
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Telephone | 215-955-6776
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 OLD YORK RD FL 1
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City | ABINGTON
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State | PA
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Zip | 19001-3720
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Country | US
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Telephone | 215-481-3145
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Fax | 215-481-3781
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 35.150849
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD488205
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License Number State | PA
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