MEDICARE: MRS. TINA SARTZETAKIS RPH

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
1	183500000X	Pharmacist	0435251	NY

General Provider Information

NPI Number	:	1386967065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TINA SARTZETAKIS RPH

Provider Business Mailing Address
First Line	:	321 83RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4404
Country	:	US
Telephone Number	:	718-833-5747
Fax Number	:

Provider Business Practice Location Address
First Line	:	7133 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1608
Country	:	US
Telephone Number	:	718-748-1861
Fax Number	:	718-491-5527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2010
Last Update Date	:	03/09/2010

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