Healthcare Provider Details

I. General information

NPI: 1932131075
Provider Name (Legal Business Name): NIKOLAOS T PYRSOPOULOS MD,PHD,MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E 34TH ST FL 8
NEW YORK NY
10016-4910
US

IV. Provider business mailing address

700 HICKSVILLE RD STE 205
BETHPAGE NY
11714-3472
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-8133
  • Fax: 929-455-9840
Mailing address:
  • Phone: 646-501-3229
  • Fax: 212-263-4539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number326644
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number326644
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: