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NPI Code Detail

MEDICARE: GEORGIA S VASILAKIS M.D.

MEDICARE: GEORGIA S VASILAKIS 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
1207V00000XObstetrics & Gynecology Physician208398MA

General Provider Information

NPI Number : 1447207188
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGIA S VASILAKIS M.D.
Provider Business Mailing Address
First Line : 30 WASHINGTON ST
Second Line :
City : WELLESLEY
State : MA
Zip : 02481-1905
Country : US
Telephone Number : 781-263-0033
Fax Number :
Provider Business Practice Location Address
First Line : 30 WASHINGTON ST
Second Line :
City : WELLESLEY
State : MA
Zip : 02481-1905
Country : US
Telephone Number : 781-263-0033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 03/21/2011

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