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Individual

DR. EMANUEL L KOUROUPOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2747 CRESCENT ST, SUITE 206, ASTORIA, NY 11102
(718) 204-1100
(718) 204-2049
Mailing address
27-47 CRESCENT STREET, SUITE 206, ASTORIA, NY 11102
(718) 204-1100
(718) 204-2049

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
155527-1
NY
174400000X
Specialist
155527-1
NY
207RG0100X
Gastroenterology Physician
Primary
155527
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00869470
NY
Enumeration date
01/27/2006
Last updated
05/18/2018
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