Provider Demographics
NPI:1851575799
Name:SGANTZOS, HARRY II
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:SGANTZOS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16015 POWELLS COVE BLVD
Mailing Address - Street 2:
Mailing Address - City:BEECHHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1355
Mailing Address - Country:US
Mailing Address - Phone:917-494-2337
Mailing Address - Fax:347-368-6594
Practice Address - Street 1:250 WEST 57TH STREEET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-265-2101
Practice Address - Fax:212-265-2105
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0485841835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy