Provider Demographics
NPI:1154644631
Name:GEORGAKOPOULOS, MARIA (RPH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:GEORGAKOPOULOS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5706
Mailing Address - Country:US
Mailing Address - Phone:718-836-1400
Mailing Address - Fax:718-836-0086
Practice Address - Street 1:8912 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5706
Practice Address - Country:US
Practice Address - Phone:718-836-1400
Practice Address - Fax:718-836-0086
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist