Individual
PANAGIOTIS KOULOUMBINIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-7575
(845) 333-7202
Mailing address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-7575
(845) 333-7202
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
016802
NY
363AM0700X
Medical Physician Assistant
Primary
016802
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03743340
—
NY
Enumeration date
08/20/2013
Last updated
11/27/2023
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