Organization
CRESCENT ENDOSCOPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMANUEL LEONIDAS KOUROUPOS M.D (MD)
(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
261QE0800X
Endoscopy Clinic/Center
Primary
155527
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00869470
—
NY
Enumeration date
12/11/2013
Last updated
12/11/2013
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