Individual
CHRYSOULA TSIRAKIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1745 UNION BLVD, BAY SHORE, NY 11706-7952
(631) 328-5560
Mailing address
1745 UNION BLVD, BAY SHORE, NY 11706-7952
(631) 328-5560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
029906
NY
363AM0700X
Medical Physician Assistant
029906
NY
363AS0400X
Surgical Physician Assistant
029906
NY
Other
Enumeration date
09/15/2023
Last updated
12/13/2024
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