Provider Demographics
NPI:1821251315
Name:TSAMBOUKOS, KALIROI DANIELLA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KALIROI
Middle Name:DANIELLA
Last Name:TSAMBOUKOS
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 1:3419 33RD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2225
Mailing Address - Country:US
Mailing Address - Phone:718-392-3290
Mailing Address - Fax:212-741-2815
Practice Address - Street 1:33 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6602
Practice Address - Country:US
Practice Address - Phone:212-741-3365
Practice Address - Fax:212-741-2815
Is Sole Proprietor?:No
Enumeration Date:2008-07-06
Last Update Date:2008-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY043481OtherLICENSE NUJMBER