Provider Demographics
NPI:1356892988
Name:TSOUKIAS, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TSOUKIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:KOULOURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21-21 24TH STREET
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105
Mailing Address - Country:US
Mailing Address - Phone:718-974-0220
Mailing Address - Fax:
Practice Address - Street 1:21-21 24TH STREET
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105
Practice Address - Country:US
Practice Address - Phone:718-974-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst