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NPI Code Detail

MEDICARE: NESTOR KOPIDIS PT

MEDICARE: NESTOR KOPIDIS PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist011342NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OXFORDOTHERNYP2630857
2QN0401OTHERNYEMPIRE BC/BS NUMBER

General Provider Information

NPI Number : 1336119940
Entity Type Code : Individual
Provider Name (Legal Business Name) : NESTOR KOPIDIS PT
Provider Business Mailing Address
First Line : 1385 BOSTON POST RD
Second Line :
City : LARCHMONT
State : NY
Zip : 10538-3904
Country : US
Telephone Number : 914-834-7222
Fax Number :
Provider Business Practice Location Address
First Line : 52 VANDERBILT AVE
Second Line : SUITE 1413
City : NEW YORK
State : NY
Zip : 10017-3808
Country : US
Telephone Number : 212-599-0099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 07/08/2007

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