Healthcare Provider Details

I. General information

NPI: 1386876035
Provider Name (Legal Business Name): GEORGE S ANDRIOPOULOS CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 10/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 UNIVERSITY PL
NEW YORK NY
10003-4504
US

IV. Provider business mailing address

74 UNIVERSITY PL
NEW YORK NY
10003-4504
US

V. Phone/Fax

Practice location:
  • Phone: 212-473-0277
  • Fax: 212-614-6633
Mailing address:
  • Phone: 212-473-0277
  • Fax: 212-614-6633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number360101060759810
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: