Provider Demographics
NPI:1235309675
Name:MORKOS, OLGA WILLIAM (RPH)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:WILLIAM
Last Name:MORKOS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2814
Mailing Address - Country:US
Mailing Address - Phone:631-473-2914
Mailing Address - Fax:631-473-8865
Practice Address - Street 1:464 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2814
Practice Address - Country:US
Practice Address - Phone:631-473-2914
Practice Address - Fax:631-473-8865
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist