Provider Demographics
NPI:1750604278
Name:DROGARIS, GEORGE P
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:P
Last Name:DROGARIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:GEORGE
Other - Middle Name:P
Other - Last Name:DROGARIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:1796 CLOVE RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1672
Mailing Address - Country:US
Mailing Address - Phone:718-447-1206
Mailing Address - Fax:
Practice Address - Street 1:1796 CLOVE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-1672
Practice Address - Country:US
Practice Address - Phone:718-447-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist