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Individual
DR. THOMAS N KOUTELOS
Active
Individual
DR. THOMAS N KOUTELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
INTERNAL MEDICINE
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19052 1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01366774
—
NY
01
—
10L46
EMPIRE BC-BS
NY
01
—
11 0240756
RAILROAD MEDICARE
NY
01
—
113416490
MAGNACARE
NY
01
—
190521
HIP OF NY
NY
01
—
2023469
AETNA HMO PPO
NY
01
—
33D0709729
CLEAR#
NY
01
—
5699985
GHI
NY
01
—
6638812006
CIGNA PPO HMO
NY
01
—
IC7375
ACS HEALTHNET OF NE
NY
01
—
P809058
OXFORD
NY
Enumeration date
11/20/2006
Last updated
07/08/2007
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