Basic Information
| Provider Information | |||||||||
| NPI: | 1720035926 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TJOUMAKARIS | ||||||||
| FirstName: | FOTIOS | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 833 CHESTNUT ST STE 520 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003219999 | ||||||||
| FaxNumber: | 2673393761 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 COURT HOUSE SOUTH DENNIS RD | ||||||||
| Address2: | |||||||||
| City: | CAPE MAY COURT HOUSE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082102126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003219999 | ||||||||
| FaxNumber: | 2674791321 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 03/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 25MA08019200 | NJ | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | MD420433 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | ME152830 | FL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 303457 | NY | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0005X | 25MA08019200 | NJ | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0104795 | 05 | NJ | MEDICAID | P00344963 | 01 | NJ | RAILROAD MEDICARE | OTHER |