Individual provider · NPI-1

Dr. Anastasia Bakoulis, D.O.

Surgery · Stony Brook, NY

NPI number1922380203
StatusActive
Last updated in NPPESJul 21, 2022

Details

NPI
1922380203
Entity type
Individual (NPI-1)
Name
Dr. Anastasia Bakoulis
Credential
D.O.
Sex
Female
Sole proprietor
No
Enumeration date
Sep 13, 2011
Last updated
Jul 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery284277NYYes

Practice location

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794-2594

Phone 631-638-1000 · Fax 631-638-0720

Mailing address

Stony Brook Surgical Associates Hsc T19, Room 20
Stony Brook, NY 11794-8191

Phone 631-444-5976 · Fax 631-444-6348

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