Provider Demographics
NPI:1235341959
Name:TRIKOUNAKIS, STEVE (RPA-C)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:TRIKOUNAKIS
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MOHAWK RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5026
Mailing Address - Country:US
Mailing Address - Phone:914-589-3170
Mailing Address - Fax:
Practice Address - Street 1:2 SUFFERN LN
Practice Address - Street 2:
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923-1311
Practice Address - Country:US
Practice Address - Phone:845-429-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMT1352361363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02768505Medicaid
NY6169LAW991Medicare ID - Type Unspecified
NYQ65874Medicare UPIN