Individual
MR. DIMITRI GEORGE PANOUSSIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
445 OAK ST, COPIAGUE, NY 11726-3111
(631) 257-5173
Mailing address
66 HALLEY DR, BLUE POINT, NY 11772
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NY
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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