Provider Demographics
NPI:1619243110
Name:VASILIOU, ELYA HORATTAS (MD)
Entity Type:Individual
Prefix:
First Name:ELYA
Middle Name:HORATTAS
Last Name:VASILIOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELYA
Other - Middle Name:
Other - Last Name:HORATTAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 E MARKET ST
Mailing Address - Street 2:DEPARTMENT OF SURGERY
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1619
Mailing Address - Country:US
Mailing Address - Phone:330-375-3107
Mailing Address - Fax:
Practice Address - Street 1:115 PORTER DRIVE
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1619
Practice Address - Country:US
Practice Address - Phone:802-388-4701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0014175208600000X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program