Organization
KALIOPE GOUTIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALIOPE GOUTIS (LPN)
(727) 946-3963
Entity
Organization
Contact information
Practice address
8323E MIDDLE LEWIS AVE, FORT DRUM, NY 13603-2024
(727) 946-3963
Mailing address
8323E MIDDLE LEWIS AVE, FORT DRUM, NY 13603-2024
(727) 946-3963
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
3178921
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03934241
—
NY
Enumeration date
11/05/2016
Last updated
11/05/2016
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