Provider Demographics
NPI:1669507398
Name:PITSIOS, VASILIOS (MD)
Entity Type:Individual
Prefix:
First Name:VASILIOS
Middle Name:
Last Name:PITSIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3318
Mailing Address - Country:US
Mailing Address - Phone:845-678-3434
Mailing Address - Fax:845-708-2206
Practice Address - Street 1:155 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5523
Practice Address - Country:US
Practice Address - Phone:914-372-7171
Practice Address - Fax:914-909-4182
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1893112207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01407758Medicaid
NYF444599Medicare UPIN
NY01407758Medicaid