Healthcare Provider Details

I. General information

NPI: 1730145665
Provider Name (Legal Business Name): ANTONIOS ZIKOS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 E NORTH AVE SUITE 300
PITTSBURGH PA
15212-4740
US

IV. Provider business mailing address

490 E NORTH AVE SUITE 300
PITTSBURGH PA
15212-4771
US

V. Phone/Fax

Practice location:
  • Phone: 412-322-7202
  • Fax: 412-322-2144
Mailing address:
  • Phone: 412-322-7202
  • Fax: 412-322-2144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberOS005431L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberOS005431L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: