Healthcare Provider Details

I. General information

NPI: 1124395314
Provider Name (Legal Business Name): STAMATIOS LEONIDAS KATSIKIS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVE LEONIDAS KATSIKIS PHARMD

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 FELLOWSHIP RD STE 101
MOUNT LAUREL NJ
08054-1201
US

IV. Provider business mailing address

350 FELLOWSHIP RD STE 101
MOUNT LAUREL NJ
08054-1201
US

V. Phone/Fax

Practice location:
  • Phone: 844-425-3687
  • Fax: 856-344-1520
Mailing address:
  • Phone: 844-425-3687
  • Fax: 856-344-1520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RIO3149100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: