Dimirtios Kostopoulos PTPC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

011188-1 Issued in NY

Legal business name

DIMIRTIOS KOSTOPOULOS PTPC

Practice address

3244 31St St
Astoria, NY 11106-2644

Phone

(718) 707-6970

Fax

(718) 732-2864

NPI assigned

Jun 3, 2008

Organization subpart

No

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

Authorized official

Name

Dimitrios Kostopoulos, PT PHD DSC

Title

Owner

Phone

(718) 707-6970

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380585600000",
    "number": "1790944981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3244 31ST ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111062644",
            "telephone_number": "718-707-6970",
            "fax_number": "718-732-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3244 31ST ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111062644",
            "telephone_number": "718-707-6970",
            "fax_number": "718-732-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMIRTIOS KOSTOPOULOS PTPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2013-10-01",
        "status": "A",
        "authorized_official_last_name": "KOSTOPOULOS",
        "authorized_official_first_name": "DIMITRIOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-707-6970",
        "authorized_official_credential": "PT PHD DSC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "011188-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G100000062",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Astoria, NY
• Providers in Astoria, 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 Oct 1, 2013; 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.