Basic Information
Provider Information
NPI: 1710299649
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TSATIRIS
FirstName: DIMITRIOS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5655 HUDSON DR STE 305
Address2:  
City: HUDSON
State: OH
PostalCode: 442364454
CountryCode: US
TelephoneNumber: 3306502111
FaxNumber:  
Practice Location
Address1: 11100 EUCLID AVE
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441061716
CountryCode: US
TelephoneNumber: 2168443450
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/08/2010
LastUpdateDate: 08/12/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/12/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X35.123379OHY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


Home