Individual
MR. IVAN LEONIDAS GIANNOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
998 CROOKED HILL RD, WEST BRENTWOOD, NY 11717-1019
(631) 761-3500
(631) 761-2600
Mailing address
998 CROOKED HILL RD, WEST BRENTWOOD, NY 11717-1019
(646) 644-6199
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
669877
NY
Other
Enumeration date
09/15/2019
Last updated
09/23/2019
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