Healthcare Provider Details

I. General information

NPI: 1104089085
Provider Name (Legal Business Name): ALEXANDER GEORGE TZAVARAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 E TREMONT AVE
BRONX NY
10465-2422
US

IV. Provider business mailing address

3860 E TREMONT AVE
BRONX NY
10465-2422
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-1592
  • Fax:
Mailing address:
  • Phone: 718-881-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number248887-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: