Provider Demographics
NPI:1841826773
Name:TSOURISTAKIS, ALINA I (MS, MD)
Entity type:Individual
Prefix:DR
First Name:ALINA
Middle Name:I
Last Name:TSOURISTAKIS
Suffix:
Gender:F
Credentials:MS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5431
Mailing Address - Country:US
Mailing Address - Phone:203-327-1055
Mailing Address - Fax:
Practice Address - Street 1:126 MORGAN ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5431
Practice Address - Country:US
Practice Address - Phone:203-327-1055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT76754208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics