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Individual

DR. JOHN PETER VAKIOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
ONE GUTHRIE SQUARE, SAYRE, PA 18840
(570) 882-4048
(570) 822-5166
Mailing address
PO BOX 188, SAYRE, PA 18840-0188
(570) 882-4048
(570) 882-5166

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
193492
NY
2085R0203X
Therapeutic Radiology Physician
193492
NY
208VP0000X
Pain Medicine Physician
193492
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01897236
NY
01
CC9269
RR MEDICARE GROUP ID
PA
01
P00635209
RR MEDICARE PIN
PA
Enumeration date
06/01/2006
Last updated
05/11/2009
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