Provider Demographics
NPI:1942522594
Name:AMIGDALOS, STEVE S (RPH)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:S
Last Name:AMIGDALOS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ODELL PLZ
Mailing Address - Street 2:SUITES B & C
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1406
Mailing Address - Country:US
Mailing Address - Phone:914-375-4300
Mailing Address - Fax:914-457-7626
Practice Address - Street 1:5 ODELL PLZ
Practice Address - Street 2:SUITES B & C
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1406
Practice Address - Country:US
Practice Address - Phone:914-375-4300
Practice Address - Fax:914-457-7626
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045825183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist