Provider Demographics
NPI:1184845661
Name:VLAHOS, THERESA MARIE (NP)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:MARIE
Last Name:VLAHOS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:58 HILDEN ST
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-1768
Mailing Address - Country:US
Mailing Address - Phone:631-444-9267
Mailing Address - Fax:631-444-1211
Practice Address - Street 1:STONYBROOK UNIVERSITY MEDICAL CTR
Practice Address - Street 2:SUNY - 9440
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-9440
Practice Address - Country:US
Practice Address - Phone:631-444-9267
Practice Address - Fax:631-444-1211
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF300544-1363LA2200X
NYF381179-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics