Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 023217 | NY |
NPI | 1376008003 |
---|---|
Provider Name | Diana Tsukalas |
First Address | Pleasantville, NY 10570-2402 |
Second Address | New York, NY 10038-2612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2019 |
Last Update Date | 12/03/2021 |