Basic Information
Provider Information
NPI: 1356303283
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DRAKATOS
FirstName: SPIRO
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: DPM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 64 LIBERTY CMN
Address2:  
City: RYE
State: NH
PostalCode: 038702013
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 718 SMYTH RD
Address2: MANCHESTER VAMC
City: MANCHESTER
State: NH
PostalCode: 031047004
CountryCode: US
TelephoneNumber: 6036244366
FaxNumber: 6036293264
Other Information
ProviderEnumerationDate: 04/05/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213E00000X0284NHY Podiatric Medicine & Surgery Service ProvidersPodiatrist 

No ID Information.


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