Provider Demographics
NPI:1427372945
Name:MASAKOS, EVANGELIA (PHARM D)
Entity Type:Individual
Prefix:MISS
First Name:EVANGELIA
Middle Name:
Last Name:MASAKOS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23318 40TH AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1530
Mailing Address - Country:US
Mailing Address - Phone:718-819-0950
Mailing Address - Fax:718-819-0951
Practice Address - Street 1:73 COVERT AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-3218
Practice Address - Country:US
Practice Address - Phone:516-354-1227
Practice Address - Fax:516-354-0974
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist