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NPI Code Detail

MEDICARE: DR. ANDRE GEORGE GIANNAKOPOULOS M.D.

MEDICARE: DR. ANDRE GEORGE GIANNAKOPOULOS M.D.
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
1207R00000XInternal Medicine Physician236820NY

General Provider Information

NPI Number : 1407942162
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDRE GEORGE GIANNAKOPOULOS M.D.
Provider Business Mailing Address
First Line : 205 CYPRESS LN W.
Second Line :
City : WESTBURY
State : NY
Zip : 11590
Country : US
Telephone Number : 516-833-6331
Fax Number : 516-333-5585
Provider Business Practice Location Address
First Line : 2578 HEMPSTEAD TPKE
Second Line :
City : EAST MEADOW
State : NY
Zip : 11554-2136
Country : US
Telephone Number : 516-333-5555
Fax Number : 516-333-5585
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 11/23/2015

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