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Individual

DR. EMANUEL KOSTAKOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
460 OLD TOWN RD APT 8J, PORT JEFFERSON STATION, NY 11776-2216
(631) 474-0901
Mailing address
460 OLD TOWN RD APT 8J, PORT JEFFERSON STATION, NY 11776-2216
(631) 474-0901

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
010590-1
NY
103TC0700X
Clinical Psychologist
010590-1
NY
103TS0200X
School Psychologist
Primary
010590-1
NY

Other

Enumeration date
05/23/2007
Last updated
09/11/2025
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