Kostakos, Emanuel

Kostakos, Emanuel is an sole proprietor health care provider with primary practice located at 460 Old Town Rd Apt 8J , Port Jefferson Station NY 11776-2216. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Kostakos, Emanuel can be contacted via phone (631) 474-0901.

Contact Information

Primary practice address
460 Old Town Rd Apt 8J Port Jefferson Station NY 11776-2216
Phone: (631) 474-0901
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 010590-1 New York
Behavioral Health & Social Service Providers / Clinical 103TC0700X 010590-1 New York
Behavioral Health & Social Service Providers / School 103TS0200X 010590-1 New York

Profile Details

NPI number 1316157134
LBN Legal business name Kostakos, Emanuel
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers