| Emanuel L. Kouroupos, M.d., P.c. | |
|
2747 Crescent St Suite 206 Astoria NY 11102-3142 | |
| (718) 204-1100 | |
| (718) 204-2049 |
| Full Name | Emanuel L. Kouroupos, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2747 Crescent St, Astoria, New York |
| Authorized Official Name and Position | Emanuel L. Kouroupos (PROPRIETOR) |
| Authorized Official Contact | 7182041100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emanuel L. Kouroupos, M.d., P.c. 2747 Crescent St Suite 206 Astoria NY 11102-3142 Ph: (718) 204-1100 | Emanuel L. Kouroupos, M.d., P.c. 2747 Crescent St Suite 206 Astoria NY 11102-3142 Ph: (718) 204-1100 |
| NPI Number | 1457408163 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 09/07/2007 |
| Medicare PECOS PAC ID | 8123127933 |
|---|---|
| Medicare Enrollment ID | O20070620000123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457408163 | NPI | - | NPPES |
| 872420 | Other | AETNA | |
| 28110P | Other | HIP | |
| 00869470 | Medicaid | NY | |
| 34D462 | Other | NY | BLUE CROSS BLUE SHIELD |
| DP282 | Other | NY | OXFORD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Changcheng Zhu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1407936909 PECOS PAC ID: 8527164805 Enrollment ID: I20070502000563 |
| Provider Name | Emanuel L Kouroupos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043281280 PECOS PAC ID: 3577662394 Enrollment ID: I20080114000324 |
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