Individual
DR. TASIOS G. VAKKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
77 QUAKER RIDGE RD, SUITE 212, NEW ROCHELLE, NY 10804-2808
(914) 235-1235
(914) 235-0194
Mailing address
1565 MIDLAND AVE, 2ND FLOOR, BRONXVILLE, NY 10708-6039
(914) 202-9639
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
052718
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
240882
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02802202
—
NY
05
—
02813798
—
NY
Enumeration date
12/04/2006
Last updated
02/18/2009
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