Provider Demographics
NPI:1033432141
Name:ATHANASOPOULOS, CHRISOULA I (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISOULA
Middle Name:
Last Name:ATHANASOPOULOS
Suffix:I
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2804
Mailing Address - Country:US
Mailing Address - Phone:914-771-5853
Mailing Address - Fax:
Practice Address - Street 1:370 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2804
Practice Address - Country:US
Practice Address - Phone:914-771-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist