Provider Demographics
NPI:1962790279
Name:ZOIS, THEOFANIS P (RPA-C)
Entity type:Individual
Prefix:
First Name:THEOFANIS
Middle Name:P
Last Name:ZOIS
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 UNION PL
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-4126
Mailing Address - Country:US
Mailing Address - Phone:516-599-2914
Mailing Address - Fax:
Practice Address - Street 1:110 UNION PL
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-4126
Practice Address - Country:US
Practice Address - Phone:516-599-2914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14896363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical