Provider Demographics
NPI:1114094083
Name:ANGELAKOS, THESSALONIKI (MD)
Entity Type:Individual
Prefix:DR
First Name:THESSALONIKI
Middle Name:
Last Name:ANGELAKOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:NIKKI
Other - Middle Name:
Other - Last Name:TSIRILAKIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:36 CRANE ROAD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-725-5120
Mailing Address - Fax:914-725-5975
Practice Address - Street 1:36 CRANE ROAD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-725-5120
Practice Address - Fax:914-725-5975
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136060207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
03806OtherGHI MEDICARE
NY00325746Medicaid
108156OtherGHI HMO
177901OtherHIP
177909OtherHIP
0040139OtherGHI
0004278457OtherAETNA
35364200OtherBCBS
177912OtherHIP
8350296OtherCIGNA
P2819658OtherOXFORD
A62480Medicare UPIN
NY00325746Medicaid