Provider Demographics
NPI:1891850541
Name:PAPADOULIAS, STEPHEN NICHOLAS (PHARMD, RPH, RXM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:NICHOLAS
Last Name:PAPADOULIAS
Suffix:
Gender:M
Credentials:PHARMD, RPH, RXM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 DWIGHT RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-3465
Mailing Address - Country:US
Mailing Address - Phone:413-736-7847
Mailing Address - Fax:
Practice Address - Street 1:188 UNION ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-2429
Practice Address - Country:US
Practice Address - Phone:860-896-1485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist