| Doctor Name: | DR. NICHOLAS A. PATSARISIS |
| NPI Number: | 1417115122 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MEDICAL DOCTOR |
| License Number: | 096200 |
| Business Practice Address: | 2567 33rd St Private Home Astoria, NY - 111021235 |
| Business Phone Number: | 7189327660 |
| Business Fax Number: | 7186263835 |
| Mailing Address: | 2567 33rd St, Private Home ASTORIA |
| State: | NY |
| Postal Code: | 111021235 |
| Phone Number: | 7189327660 |
| Fax Number: | 7186263835 |
| NPI Enumeration Date: | 05/29/2008 |
| NPI Last Update Date: | 05/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 096200 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |