Provider Demographics
NPI:1710128939
Name:TZORZIS, THALIA (MA, PD)
Entity Type:Individual
Prefix:MRS
First Name:THALIA
Middle Name:
Last Name:TZORZIS
Suffix:
Gender:F
Credentials:MA, PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1420
Mailing Address - Country:US
Mailing Address - Phone:917-605-4267
Mailing Address - Fax:
Practice Address - Street 1:29 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-1420
Practice Address - Country:US
Practice Address - Phone:917-605-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool