Provider Demographics
NPI:1316296544
Name:TSIROGIANNIS, VASILIKY (MD)
Entity type:Individual
Prefix:
First Name:VASILIKY
Middle Name:
Last Name:TSIROGIANNIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 PATERSON PLANK RD
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3746
Mailing Address - Country:US
Mailing Address - Phone:201-583-5232
Mailing Address - Fax:201-351-4016
Practice Address - Street 1:1325 PATERSON PLANK RD
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3746
Practice Address - Country:US
Practice Address - Phone:201-583-5232
Practice Address - Fax:201-351-4016
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08733800208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist