Provider Demographics
NPI:1073746905
Name:GIOUROUKAKIS, MARY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:GIOUROUKAKIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NICOLS ROAD
Mailing Address - Street 2:STONY BROOK UNIVERSITY MEDICAL CENTER/PHARMACY DEPT
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 NICOLS ROAD
Practice Address - Street 2:STONY BROOK UNIVERSITY MEDICAL CENTER/PHARMACY DEPT
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-444-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist