Organization
EMANUEL L. KOUROUPOS, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMANUEL L. KOUROUPOS M.D. (PROPRIETOR)
(718) 204-1100
Entity
Organization
Contact information
Practice address
2747 CRESCENT ST, SUITE 206, ASTORIA, NY 11102-3142
(718) 204-1100
(718) 204-2049
Mailing address
2747 CRESCENT ST, SUITE 206, ASTORIA, NY 11102-3142
(718) 204-1100
(718) 204-2049
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00869470
—
NY
01
—
28110P
HIP
—
01
—
34D462
BLUE CROSS BLUE SHIELD
NY
01
—
872420
AETNA
—
01
—
DP282
OXFORD
NY
Enumeration date
01/04/2007
Last updated
09/07/2007
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