Provider Demographics
NPI:1295095743
Name:STAMATIS, MARIA (PHARMD)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:STAMATIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3152
Mailing Address - Country:US
Mailing Address - Phone:631-447-6282
Mailing Address - Fax:631-447-1465
Practice Address - Street 1:655 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3152
Practice Address - Country:US
Practice Address - Phone:631-447-6282
Practice Address - Fax:631-447-1465
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI056628-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist