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NPI 1548472186

NPI 1548472186 : KATERINA STEFANOU BS : WEST PATCHOGUE, NY

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General NPI Number Information
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    NPI Number           |    1548472186
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    Entity Type          |    Individual 
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    Provider Name        |    KATERINA STEFANOU BS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/04/2007
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    Last Update Date     |    05/20/2016
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Provider Practice Location Address
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    Address Line         |    296 WEST PATCHOGUE 
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    City                 |    WEST PATCHOGUE
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    State                |    NY
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    Zip                  |    11772
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    Country              |    US
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    Telephone            |    631-654-1333
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    864 MIDDLE COUNTRY RD 
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    City                 |    MIDDLE ISLAND
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    State                |    NY
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    Zip                  |    11953-2524
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    Country              |    US
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    Telephone            |    631-924-8500
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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       |    038631
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    License Number State |    NY
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