Most Relevant Information
Provider Data
| NPI Number: | 1003366576 |
| Provider Name: | COSTANTINOS STAMBOULIS OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 020698 |
Most Important Dates
| Enumeration Date: | 10/09/2016 |
| Last Updated: | 05/13/2021 |
Provider Practice Location
2408 32ND ST STE 1002D
ASTORIA
NY
111021139
Practice Location Phone/Fax
| Phone: | 7187342373 |
| Fax: | 7187342372 |
Provider Mailing Location
14916 17TH RD
WHITESTONE
NY
113572542
Provider Mailing Phone/Fax
| Phone: | 9176623041 |
| Fax: |