Individual
MR. ALEXANDER DRAKONTAIDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 WILSON AVE, KINGSTON, NY 12401-2110
(845) 399-4147
(845) 399-4147
Mailing address
30 WILSON AVE, KINGSTON, NY 12401-2110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
094842-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255606406
—
NY
Enumeration date
05/09/2016
Last updated
05/11/2020
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