Provider Demographics
NPI:1225256449
Name:SARIKAS, CONSTANTINOS P (LAC, LMT)
Entity Type:Individual
Prefix:MR
First Name:CONSTANTINOS
Middle Name:P
Last Name:SARIKAS
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 COMMONWEALTH STREET
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010
Mailing Address - Country:US
Mailing Address - Phone:516-328-9647
Mailing Address - Fax:516-232-2438
Practice Address - Street 1:190 COMMONWEALTH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-4218
Practice Address - Country:US
Practice Address - Phone:516-328-9647
Practice Address - Fax:516-232-2438
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12188171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist