Dr Paul Poulakos DO, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DR PAUL POULAKOS DO, LLC

Practice address

412 6TH Avenue
Floor 7, Suite 702
New York, NY 10011-4918

Phone

(917) 275-3625

NPI assigned

Mar 5, 2020

Organization subpart

No

Name

Dr. Paul Poulakos, DONPI 1558715383

Title

Physician

Phone

(917) 275-3625

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Emmanuel Poulakos, D.O.

  • Psychiatry Physician
  • New York, NY
  • NPI 1558715383
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 3, 2024.

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1104451525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 6TH AVENUE",
            "address_2": "FLOOR 7, SUITE 702",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114918",
            "telephone_number": "917-275-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 6TH AVENUE",
            "address_2": "FLOOR 7, SUITE 702",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114918",
            "telephone_number": "917-275-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR PAUL POULAKOS DO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-05",
        "last_updated": "2024-07-03",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "POULAKOS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "917-275-3625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in New York, NY
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.