Provider Demographics
NPI:1992994651
Name:TSOUKAS, ELIAS NICHOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:NICHOLAS
Last Name:TSOUKAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CHARLDEN DR
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2801
Mailing Address - Country:US
Mailing Address - Phone:201-327-8138
Mailing Address - Fax:201-327-1138
Practice Address - Street 1:25 CHARLDEN DR
Practice Address - Street 2:
Practice Address - City:SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-2801
Practice Address - Country:US
Practice Address - Phone:201-327-8138
Practice Address - Fax:201-327-1138
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA01937700208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)