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NPI Code Detail

MEDICARE: SOPHIA IRENE SKOULOUDIS PHARMD

MEDICARE: SOPHIA IRENE SKOULOUDIS PHARMD
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
1183500000XPharmacist073797NY

General Provider Information

NPI Number : 1205783412
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA IRENE SKOULOUDIS PHARMD
Provider Business Mailing Address
First Line : 56 CHESTER HILL RD
Second Line :
City : WARWICK
State : NY
Zip : 10990-2556
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 245 E MAIN ST
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-4017
Country : US
Telephone Number : 845-344-1056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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