Individual
MR. MICHAEL ANTONIS KOULLIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1070 66TH ST, BROOKLYN, NY 11219-5939
(646) 642-6269
Mailing address
1070 66TH ST, BROOKLYN, NY 11219-5939
(646) 642-6269
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
4175
NY
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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