Provider Demographics
NPI:1255936886
Name:WORKSEW, TINOS
Entity type:Individual
Prefix:
First Name:TINOS
Middle Name:
Last Name:WORKSEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10037 BUTTERNUT CT N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1881
Mailing Address - Country:US
Mailing Address - Phone:585-201-9459
Mailing Address - Fax:
Practice Address - Street 1:4400 OAK GROVE PKWY N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55443-4001
Practice Address - Country:US
Practice Address - Phone:585-201-9459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist