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General NPI Number Information
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NPI Number | 1265709265
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Entity Type | Individual
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Provider Name | GEORGE ANGELOPOULOS PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 11/19/2011
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 64 INDIAN HEAD RD
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City | KINGS PARK
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State | NY
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Zip | 11754-3703
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Country | US
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Telephone | 631-663-3800
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Fax | 631-663-3799
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Provider Business Mailing Address
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Address Line | 10 ROOSEVELT AVE
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776
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Country | US
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Telephone | 631-886-2844
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Fax | 631-886-2842
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 040973-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 040973-1
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License Number State | NJ
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