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General NPI Number Information
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NPI Number | 1710333430
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Entity Type | Organization
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Legal Business Name | PAULA C. TZIKAS, PSYCHOLOGIST, PLLC
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 248 DOVER PKWY
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City | STEWART MANOR
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State | NY
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Zip | 11530-5024
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Country | US
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Telephone | 917-509-7323
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Fax |
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Provider Business Mailing Address
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Address Line | 248 DOVER PKWY
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City | STEWART MANOR
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State | NY
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Zip | 11530-5024
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Country | US
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Telephone | 917-509-7323
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. PAULA C TZIKAS
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Credential | PH.D.
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Telephone | 917-509-7323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 015149
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License Number State | NY
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