Kimberly K Stavrolakes, P.T.

Primary specialty

Cardiopulmonary Physical TherapistTaxonomy code 2251C2600X

License

012683-1 Issued in NY

Practice address

622 W 168TH St
VC 3-363
New York, NY 10032-3720

Phone

(212) 305-0890

Fax

(212) 305-0412

NPI assigned

Apr 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679792055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CEDAR HILL RD",
            "city": "BEDFORD",
            "state": "NY",
            "postal_code": "105062017",
            "telephone_number": "212-305-0890",
            "fax_number": "212-305-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "VC 3-363",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-0890",
            "fax_number": "212-305-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVROLAKES",
        "first_name": "KIMBERLY",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251C2600X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": "NY",
            "license": "012683-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Stauffer, MD
• Konstantina Sophia Staurulakis, RDN
• Marney Sarah Staviss
• Olga Stavredes
• Katherine Stavrianopoulos, PH.D
• Christine Stavropoulos, MD
• Christos I Stavropoulos, M. D.
• Maria Stavropoulos, RD
• Samantha K Stavropoulos
• Jared E Stavsky, DMD

• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.