Provider Demographics
NPI:1184360547
Name:TRYFONOS, ANNA (MD)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:TRYFONOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 CLARKSON AVENUE
Mailing Address - Street 2:APARTMENT 825
Mailing Address - City:BROOKLYN-NY CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11226
Mailing Address - Country:US
Mailing Address - Phone:516-404-8402
Mailing Address - Fax:
Practice Address - Street 1:450 CLARKSON AVENUE
Practice Address - Street 2:SUNY DOWNSTATE MEDICAL CENTER
Practice Address - City:BROOKLYN, NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-270-2078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2023-01-13
Deactivation Date:2022-12-19
Deactivation Code:
Reactivation Date:2023-01-13
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program