Healthcare Provider Details

I. General information

NPI: 1952568339
Provider Name (Legal Business Name): DR. EFSTATHIA TZATHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 EARLE OVINGTON BLVD
UNIONDALE NY
11553-3610
US

IV. Provider business mailing address

PO BOX 29234
NEW YORK NY
10087-9234
US

V. Phone/Fax

Practice location:
  • Phone: 212-743-3528
  • Fax:
Mailing address:
  • Phone: 516-743-3528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number266610
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: