Individual
EVANGELIA KONTAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
524 OLD COUNTRY RD, PLAINVIEW, NY 11803-6502
(516) 931-3988
Mailing address
277 BOW DR, HAUPPAUGE, NY 11788-1626
(646) 425-0823
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
01207701
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01207701
NYS LICENSE
NY
Enumeration date
10/19/2007
Last updated
10/17/2016
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