Provider Demographics
NPI:1780308106
Name:RELATED SURGICAL SPECIALTIES, PC
Entity type:Organization
Organization Name:RELATED SURGICAL SPECIALTIES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:TSOUKALAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-250-4958
Mailing Address - Street 1:1060 FIFTH AVENUE, SUITE 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128
Mailing Address - Country:US
Mailing Address - Phone:917-250-4958
Mailing Address - Fax:718-545-0333
Practice Address - Street 1:1060 FIFTH AVENUE, SUITE 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128
Practice Address - Country:US
Practice Address - Phone:917-250-4958
Practice Address - Fax:718-545-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty