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NPI Code Detail

MEDICARE: MR. GEORGE APOSTOLOS MITSOPOULOS RPH.

MEDICARE: MR. GEORGE APOSTOLOS MITSOPOULOS RPH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist041206NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1041206OTHERNYPHARMACIST LICENSE

General Provider Information

NPI Number : 1669795589
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GEORGE APOSTOLOS MITSOPOULOS RPH.
Provider Business Mailing Address
First Line : 2202 AVENUE U
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-3648
Country : US
Telephone Number : 718-368-3900
Fax Number : 718-368-1818
Provider Business Practice Location Address
First Line : 2202 AVENUE U
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-3648
Country : US
Telephone Number : 718-368-3900
Fax Number : 718-368-1818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2010
Last Update Date : 03/05/2010

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