Healthcare Provider Details

I. General information

NPI: 1417945825
Provider Name (Legal Business Name): LOUIS TSAROUHAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 PRINCETON PIKE SUITE 3
LAWRENCEVILLE NJ
08648-3261
US

IV. Provider business mailing address

2402 NOTTINGHAM WAY
MERCERVILLE NJ
08619-4102
US

V. Phone/Fax

Practice location:
  • Phone: 609-882-9333
  • Fax: 609-882-1026
Mailing address:
  • Phone: 609-838-7933
  • Fax: 609-838-7935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA51969
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: