Organization
GLEN OAKS INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLGA KOURUKLIS M.D. (PRACTICE OWNER)
(718) 347-7090
Entity
Organization
Contact information
Practice address
26004 80TH AVE, GLEN OAKS, NY 11004-1502
(718) 347-7090
(718) 343-1453
Mailing address
26004 80TH AVE, GLEN OAKS, NY 11004-1502
(718) 347-7090
(718) 343-1453
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
244811
NY
Other
Enumeration date
02/02/2015
Last updated
12/14/2015
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