Provider Demographics
NPI:1104409770
Name:ANASTASAKIS, IAKOVOS
Entity type:Individual
Prefix:
First Name:IAKOVOS
Middle Name:
Last Name:ANASTASAKIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13901 COALFIELD COMMONS PL STE 102
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-1219
Mailing Address - Country:US
Mailing Address - Phone:804-378-0800
Mailing Address - Fax:
Practice Address - Street 1:13901 COALFIELD COMMONS PL STE 102
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-1219
Practice Address - Country:US
Practice Address - Phone:804-378-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012763582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry