Koullias, George John

Koullias, George John is an individual health care provider with primary practice located at 100 Hospital Rd Suite 203, East Patchogue NY 11772-8809. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Koullias, George John can be contacted via phone (631) 438-5030.

Contact Information

Primary practice address
100 Hospital Rd Suite 203 East Patchogue NY 11772-8809
Phone: (631) 438-5030
Fax: (631) 447-5954
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 036119605 Illinois

Profile Details

NPI number 1992986509
LBN Legal business name Koullias, George John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 26th, 2007
Last updated Nov 14th, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992986509 NPPES
Illinois Other 03619605 IL LICENSE
Illinois Other 039729 IL LICENSE
Illinois Other 262079 IL LICENSE

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