Individual
DEMETRIUS MOUTSIAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
400 HORSEBLOCK RD, FARMINGVILLE, NY 11738-1252
(631) 698-1552
Mailing address
400 HORSEBLOCK RD, FARMINGVILLE, NY 11738-1252
(631) 698-1552
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
212315-1
NY
208D00000X
General Practice Physician
Primary
212315-1
NY
Other
Enumeration date
04/01/2010
Last updated
04/01/2010
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