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General NPI Number Information
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NPI Number | 1376857631
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Entity Type | Individual
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Provider Name | CHRYSOULA KOUVAROS PHARM. D
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Gender | Female
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 52 DUANE ST
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City | NEW YORK
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State | NY
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Zip | 10007-1207
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Country | US
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Telephone | 646-680-1180
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Fax |
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Provider Business Mailing Address
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Address Line | 14619 35TH AVE
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City | FLUSHING
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State | NY
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Zip | 11354-3736
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Country | US
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Telephone | 718-539-8947
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20054771
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License Number State | NY
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