Healthcare Provider Details

I. General information

NPI: 1497923585
Provider Name (Legal Business Name): DIAMANTO TSAKANIKAS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 E 72ND ST SUITE 500
NEW YORK NY
10021-4635
US

IV. Provider business mailing address

428 E 72ND ST SUITE 500
NEW YORK NY
10021-4635
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2441
  • Fax: 212-746-5584
Mailing address:
  • Phone: 212-746-2441
  • Fax: 212-746-5584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number017454
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: