Sophia Boulukos (NPI# 1922259878, PAC ID# 8921139635) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
Nation Provider ID (NPI) | 1922259878 |
PAC ID by PECOS | 8921139635 |
Professional Enrollment ID | I20100624000356 |
Full Name | Sophia Boulukos |
Organization Legal Name | PHYSICIANS PRIVATE PRACTICE, PLLC |
Address |
222 Middle Country Rd Suite 103 Smithtown NY 11787-2834 |
Phone Number | 6312652222 |
Gender | F |
Graduation Year | 2004 |
Primary Specialty | INTERNAL MEDICINE |
Group Practice PAC ID | 9436274776 |
Number of Group Practice Members | 2 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
330106 | NS/LIJ HS-NORTH SHORE UNIVERSITY HOSPITAL AT MANHASSET |
330393 | SUNY/STONY BROOK UNIVERSITY HOSPITAL |
Address | Phone | Organization |
---|---|---|
222 Middle Country Rd, Suite 103, Smithtown, NY 11787-2834 | 6312652222 | PHYSICIANS PRIVATE PRACTICE, PLLC |
Organization Legal Name | PHYSICIANS PRIVATE PRACTICE, PLLC |
Physicians | 2 |
Name | Specialty | Organization | Address |
---|---|---|---|
Martha Tsarkalis | Family Medicine | Physicians Private Practice, Pllc | 222 Middle Country Rd, Suite 103, Smithtown, NY 11787-2834 |
Street Address |
222 MIDDLE COUNTRY RD SUITE 103 |
City | SMITHTOWN |
State | NY |
Zip | 11787-2834 |
Name | Specialty | Organization | Address |
---|---|---|---|
Martha Tsarkalis | Family Medicine | Physicians Private Practice, Pllc | 222 Middle Country Rd, Suite 103, Smithtown, NY 11787-2834 |
John F Romanelli | Ophthalmology | Prohealth Care Associates LLP | 222 Middle Country Rd, Smithtown, NY 11787-2834 |
Jafar Kolahifar | Psychiatry | 222 Middle Country Rd, Suite 219, Smithtown, NY 11787-2834 |
Name | Specialty | Organization | Address |
---|---|---|---|
Ronak T Shah | Pulmonary Disease | Stony Brook Internists, University Faculty Practice Corporation | 240 Middle Country Rd, Smithtown, NY 11787 |
Haidee Ganz-bonhurst | Physical Therapy | 50 Route 111, Suite 103, Smithtown, NY 11787 | |
Paula Pagan-rosas | Clinical Social Worker | Long Island Elder Care Lcsw Pllc | 51 Rose St, Smithtown, NY 11787-1052 |
Rosemary D Cabanillas | Clinical Social Worker | Long Island Elder Care Lcsw Pllc | 51 Rose St, Smithtown, NY 11787-1052 |
Angela R Cammarata | Clinical Social Worker | Long Island Elder Care Lcsw Pllc | 51 Rose St, Smithtown, NY 11787-1052 |
Edward D Smith Iii | Clinical Social Worker | Long Island Elder Care Lcsw Pllc | 51 Rose St, Smithtown, NY 11787-1052 |
Theresa A Keane | Clinical Social Worker | Long Island Elder Care Lcsw Pllc | 51 Rose St, Smithtown, NY 11787-1052 |
Jennifer Michelle Digiovanni | Clinical Social Worker | Long Island Elder Care Lcsw Pllc | 51 Rose St, Smithtown, NY 11787-1052 |
Joanne M Varrichio | Clinical Social Worker | Long Island Elder Care Lcsw Pllc | 51 Rose St, Smithtown, NY 11787-1052 |
Colleen J Kalman | Clinical Social Worker | Long Island Elder Care Lcsw Pllc | 51 Rose St, Smithtown, NY 11787-1052 |
Find all physicians in zip 11787 |
City | SMITHTOWN |
Zip Code | 11787 |
Specialty | INTERNAL MEDICINE |
City + Specialty | SMITHTOWN + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Sophia Boulukos.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.