Individual
DR. JOHN TSOURIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2233 NESCONSET HWY, SUITE 206, LAKE GROVE, NY 11755-1000
(631) 751-4603
(631) 751-8166
Mailing address
2233 NESCONSET HWY, SUITE 206, LAKE GROVE, NY 11755-1000
(631) 751-4603
(631) 751-8166
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
N004604
NY
213EP1101X
Primary Podiatric Medicine Podiatrist
N004604
NY
213ES0000X
Sports Medicine Podiatrist
N004604
NY
213ES0131X
Foot Surgery Podiatrist
Primary
N004604
NY
Other
Enumeration date
06/09/2005
Last updated
10/16/2014
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