Provider Demographics
NPI:1295524973
Name:PHOENIX & SYCOMORE ENTERPRISES, LLC
Entity type:Organization
Organization Name:PHOENIX & SYCOMORE ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERAKITIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-742-9302
Mailing Address - Street 1:8735 DUNWOODY PL STE 8329
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2995
Mailing Address - Country:US
Mailing Address - Phone:770-742-9302
Mailing Address - Fax:
Practice Address - Street 1:8735 DUNWOODY PL STE 8329
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-2995
Practice Address - Country:US
Practice Address - Phone:770-742-9302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty