Individual
DR. JOHN KAKNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4 HUDSON VALLEY PROFESSIONAL PLZ, NEWBURGH, NY 12550-3101
(845) 561-3666
Mailing address
4 HUDSON VALLEY PROFESSIONAL PLZ, P.O. BOX 2147, NEWBURGH, NY 12550-3101
(845) 561-3666
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV004539-0
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0196240001
MEDICARE DURABLE MEDICAL
NY
01
—
1134317522
CORPORATE NPI
—
01
—
410043515
MEDICARE RAIL ROAD
NY
01
—
C40521
MEDICARE
NY
Enumeration date
09/21/2005
Last updated
04/22/2008
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