Healthcare Provider Details

I. General information

NPI: 1851575799
Provider Name (Legal Business Name): HARRY SGANTZOS II
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 WEST 57TH STREEET
NEW YORK NY
10019
US

IV. Provider business mailing address

16015 POWELLS COVE BLVD
BEECHHURST NY
11357-1355
US

V. Phone/Fax

Practice location:
  • Phone: 212-265-2101
  • Fax: 212-265-2105
Mailing address:
  • Phone: 917-494-2337
  • Fax: 347-368-6594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number048584
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: