Provider Demographics
NPI:1134451545
Name:ANDRIOTIS, DINA (RPH)
Entity type:Individual
Prefix:MS
First Name:DINA
Middle Name:
Last Name:ANDRIOTIS
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 1:5323 241ST ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1520
Mailing Address - Country:US
Mailing Address - Phone:718-219-2166
Mailing Address - Fax:
Practice Address - Street 1:77 CHRISTOPHER ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-4249
Practice Address - Country:US
Practice Address - Phone:212-255-2525
Practice Address - Fax:212-255-2524
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041028183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist