Provider Demographics
NPI:1184085177
Name:CHRISTAKOS, EUGENIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:EUGENIA
Middle Name:
Last Name:CHRISTAKOS
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 1:129 NEWTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-2324
Mailing Address - Country:US
Mailing Address - Phone:203-846-2551
Mailing Address - Fax:
Practice Address - Street 1:720 BRANCHVILLE RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-6129
Practice Address - Country:US
Practice Address - Phone:203-544-7094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist