Provider Demographics
NPI:1801102728
Name:APOTSOS, MILTIADIS
Entity type:Individual
Prefix:
First Name:MILTIADIS
Middle Name:
Last Name:APOTSOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-725-2138
Mailing Address - Fax:
Practice Address - Street 1:1540 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8400
Practice Address - Country:US
Practice Address - Phone:718-731-8733
Practice Address - Fax:718-731-5664
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054932-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist