Provider Demographics
NPI:1710333430
Name:PAULA C. TZIKAS, PSYCHOLOGIST, PLLC
Entity Type:Organization
Organization Name:PAULA C. TZIKAS, PSYCHOLOGIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:C
Authorized Official - Last Name:TZIKAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-509-7323
Mailing Address - Street 1:248 DOVER PKWY
Mailing Address - Street 2:
Mailing Address - City:STEWART MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5024
Mailing Address - Country:US
Mailing Address - Phone:917-509-7323
Mailing Address - Fax:
Practice Address - Street 1:248 DOVER PKWY
Practice Address - Street 2:
Practice Address - City:STEWART MANOR
Practice Address - State:NY
Practice Address - Zip Code:11530-5024
Practice Address - Country:US
Practice Address - Phone:917-509-7323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015149252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency