Provider Demographics
NPI:1164586673
Name:TSOUMPARIOTIS, SPIRO MICHAEL
Entity Type:Individual
Prefix:MR
First Name:SPIRO
Middle Name:MICHAEL
Last Name:TSOUMPARIOTIS
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 1:3642 204TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-1234
Mailing Address - Country:US
Mailing Address - Phone:917-747-6701
Mailing Address - Fax:718-482-0130
Practice Address - Street 1:3642 204TH ST
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-1234
Practice Address - Country:US
Practice Address - Phone:917-747-6701
Practice Address - Fax:718-482-0130
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling