Marianthi Koullias
Individual provider Active NPI Case Manager/Care Coordinator · Broad Channel, NY
NPI 1457197253 · NPPES record last updated Jul 2, 2024
Key facts
- NPI
- 1457197253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 601 Crossbay Blvd
Broad Channel, NY 11693 - Phone
- (718) 687-7708
- NPI assigned
- Jul 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
601 Crossbay Blvd
Broad Channel, NY 11693
Mailing address
601 Crossbay Blvd
Broad Channel, NY 11693
Phone (718) 687-7708
Other providers in Broad Channel, NY
- Marlina Chan-Fernandez
- Allison Chavanne
- Nicole A Fox
- Jennifer Game
- Gregory Charles Henkel
- Kerry Ann Larkin
- Ann M Mills
- Allison Ann Moynihan
- Marissa Ann Mundy
- Marcy Nussbaum
All providers in Broad Channel, NY · Case Manager/Care Coordinator in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.