Provider Demographics
NPI:1871556498
Name:FARMAKOPOULOS, DEMETRIOS (MSPT OCS)
Entity type:Individual
Prefix:MR
First Name:DEMETRIOS
Middle Name:
Last Name:FARMAKOPOULOS
Suffix:
Gender:M
Credentials:MSPT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1336
Mailing Address - Country:US
Mailing Address - Phone:914-741-2850
Mailing Address - Fax:914-741-2851
Practice Address - Street 1:465 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1336
Practice Address - Country:US
Practice Address - Phone:914-741-2850
Practice Address - Fax:914-741-2851
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016605-1225100000X
NY0166051225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q46271Medicare ID - Type Unspecified