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NPI Code Detail

MEDICARE: MR. ANTONIOS TRIFOS

MEDICARE: MR. ANTONIOS TRIFOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist044290NY

General Provider Information

NPI Number : 1063696672
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANTONIOS TRIFOS
Provider Business Mailing Address
First Line : 9304 ASTORIA BLVD
Second Line :
City : EAST ELMHURST
State : NY
Zip : 11369-1533
Country : US
Telephone Number : 718-426-3455
Fax Number : 718-426-3498
Provider Business Practice Location Address
First Line : 9304 ASTORIA BLVD
Second Line :
City : EAST ELMHURST
State : NY
Zip : 11369-1533
Country : US
Telephone Number : 718-426-3455
Fax Number : 718-426-3498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2007
Last Update Date : 12/19/2007

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Directions to “ MR. ANTONIOS TRIFOS ” Practice Location

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