Individual
THEODORE VOUGIOUKLAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-5506
Mailing address
17807 BERNARD DR, ORLAND PARK, IL 60467-9334
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
313724
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2018
Last updated
07/15/2025
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