Provider Demographics
NPI:1407827033
Name:TSIKITAS, BILL A (MD)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:A
Last Name:TSIKITAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:100 MARINA DR
Mailing Address - Street 2:APT. 604
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-1531
Mailing Address - Country:US
Mailing Address - Phone:617-481-2005
Mailing Address - Fax:
Practice Address - Street 1:55 FOGG RD
Practice Address - Street 2:HOSPITALIST PROGRAM
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2432
Practice Address - Country:US
Practice Address - Phone:781-340-8744
Practice Address - Fax:781-682-5627
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158826207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00838486Medicaid
NYB88725Medicare UPIN
NY00838486Medicaid