Basic Information
| Provider Information | |||||||||
| NPI: | 1730248659 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KLEOPOULOS M.D. | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | JOHN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 RESEARCH WAY | ||||||||
| Address2: | UNIVERSITY ASSOCIATES IN OBSTETRICS & GYNECOLOGY, UFPC | ||||||||
| City: | EAST SETAUKET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316752125 | ||||||||
| FaxNumber: | 6316752624 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SMITHTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117872812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312654567 | ||||||||
| FaxNumber: | 6312654704 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 10/29/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 149194 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.