Provider Demographics
NPI:1528365699
Name:GEORGE JOHN TSIOULIAS MEDICAL, PC
Entity Type:Organization
Organization Name:GEORGE JOHN TSIOULIAS MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:TSIOULIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-561-7673
Mailing Address - Street 1:2322 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3255
Mailing Address - Country:US
Mailing Address - Phone:917-561-7673
Mailing Address - Fax:718-278-3449
Practice Address - Street 1:2322 30TH AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3255
Practice Address - Country:US
Practice Address - Phone:917-561-7673
Practice Address - Fax:718-278-3449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2084452086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty