Healthcare Provider Details

I. General information

NPI: 1760769236
Provider Name (Legal Business Name): ELENI INTERNATIONAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 8TH AVE 2ND FLOOR SUITE A
NEW YORK NY
10011-1646
US

IV. Provider business mailing address

246 8TH AVE 2ND FLOOR SUITE A
NEW YORK NY
10011-1646
US

V. Phone/Fax

Practice location:
  • Phone: 212-414-9755
  • Fax: 212-414-9752
Mailing address:
  • Phone: 212-414-9755
  • Fax: 212-414-9752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number032291
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AVGERINI MOUZAKITIS-FAZIO
Title or Position: VICE PRESIDENT
Credential: RPH
Phone: 212-414-9755