| Doctor Name: | MR. DIMITRI J KOUMANIS |
| NPI Number: | 1003992926 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 002733 |
| Business Practice Address: | 13 Chester Street Glens Falls, NY - 128014432 |
| Business Phone Number: | 5182032593 |
| Business Fax Number: | 5183140701 |
| Mailing Address: | 13 Chester Street, GLENS FALLS |
| State: | NY |
| Postal Code: | 128014432 |
| Phone Number: | 5182032593 |
| Fax Number: | 5183140701 |
| NPI Enumeration Date: | 10/31/2006 |
| NPI Last Update Date: | 02/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0122X |
| License Number: | 002733 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Plastic and Reconstructive Surgery |
| Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |