Provider Demographics
NPI:1326752122
Name:IOANNOU, MINAS TEDDY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MINAS
Middle Name:TEDDY
Last Name:IOANNOU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4120 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5600
Mailing Address - Country:US
Mailing Address - Phone:516-520-8809
Mailing Address - Fax:516-520-2958
Practice Address - Street 1:4120 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5600
Practice Address - Country:US
Practice Address - Phone:516-520-8809
Practice Address - Fax:516-520-2958
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY070038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist