Individual
KOSTAS NEOCLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SC.D.
Contact information
Practice address
4770 SUNRISE HWY STE 106, MASSAPEQUA PARK, NY 11762-2911
(516) 261-9398
(516) 261-9399
Mailing address
PO BOX 7247-6822, PHILADELPHIA, PA 19170-0001
(914) 241-1050
(914) 242-1516
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
002493
NY
231H00000X
Audiologist
1601000605
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03686835
—
NY
Enumeration date
02/22/2012
Last updated
11/13/2019
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