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Organization
INTEGRATIVE MEDICINE OF BROOKHAVEN P.C.
Active
Organization
INTEGRATIVE MEDICINE OF BROOKHAVEN P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIMOS G KANAKOUDAS MD (OWNER/MEDICAL DIRECTOR)
(646) 824-1380
Entity
Organization
Contact information
Practice address
59 NESCONSET HWY FL 2, PORT JEFFERSON STATION, NY 11776-2628
(646) 824-1380
Mailing address
7 LOST MEADOW LN, PORT JEFFERSON, NY 11777-1127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
257261
NY
Other
Enumeration date
01/25/2018
Last updated
03/14/2021
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