Provider Demographics
NPI:1447578240
Name:KARELLAS, DEMETRIOS (PHARM D)
Entity Type:Individual
Prefix:
First Name:DEMETRIOS
Middle Name:
Last Name:KARELLAS
Suffix:
Gender:M
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 1:87 NASSAU BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1015
Mailing Address - Country:US
Mailing Address - Phone:516-292-6432
Mailing Address - Fax:
Practice Address - Street 1:197 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-1435
Practice Address - Country:US
Practice Address - Phone:516-354-5641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist