Basic Information
Provider Information
NPI: 1427315209
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARAGIANNIS TSEKOURAS
FirstName: MARIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: KARAGIANNIS
OtherFirstName: MARIA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 5300 DERRY ST FL 2
Address2:  
City: HARRISBURG
State: PA
PostalCode: 171113576
CountryCode: US
TelephoneNumber: 7178392110
FaxNumber: 7175651934
Practice Location
Address1: 13A MAIN ST STE 4
Address2:  
City: SPARTA
State: NJ
PostalCode: 07871
CountryCode: US
TelephoneNumber: 9737267400
FaxNumber: 9737267440
Other Information
ProviderEnumerationDate: 04/18/2012
LastUpdateDate: 08/22/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA01483800NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home