Provider Demographics
NPI:1669572392
Name:SAMIOS-LAGUDIS, VASILIKI (DPM)
Entity type:Individual
Prefix:DR
First Name:VASILIKI
Middle Name:
Last Name:SAMIOS-LAGUDIS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 FRANCIS LEWIS BLVD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3041
Mailing Address - Country:US
Mailing Address - Phone:718-225-8200
Mailing Address - Fax:718-225-8203
Practice Address - Street 1:4402 FRANCIS LEWIS BLVD
Practice Address - Street 2:SUITE 2A
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3041
Practice Address - Country:US
Practice Address - Phone:718-225-8200
Practice Address - Fax:718-225-8203
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY65-005622213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU77233Medicare UPIN