Organization
PRIME DIAGNOSIS MEDICAL P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VASILIKY TSIROGIANNIS M.D. (PRESIDENT)
(551) 482-6186
Entity
Organization
Contact information
Practice address
1325 PATERSON PLANK RD, SECAUCUS, NJ 07094-3746
(201) 583-5232
(201) 351-4016
Mailing address
1325 PATERSON PLANK RD, SECAUCUS, NJ 07094-3746
(201) 583-5232
(201) 351-4016
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA08733800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324655
—
NJ
Enumeration date
07/06/2015
Last updated
12/16/2016
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