Provider Demographics
NPI:1164989604
Name:HATZINIKOLAOU, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:HATZINIKOLAOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14544 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1101
Mailing Address - Country:US
Mailing Address - Phone:347-956-0899
Mailing Address - Fax:
Practice Address - Street 1:3920 BELL BLVD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2061
Practice Address - Country:US
Practice Address - Phone:718-224-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist