Provider Demographics
NPI:1063749273
Name:ZAGOREOS, WILLIAM STEVEN (RP, CCP)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:STEVEN
Last Name:ZAGOREOS
Suffix:
Gender:M
Credentials:RP, CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2711
Mailing Address - Country:US
Mailing Address - Phone:609-896-1707
Mailing Address - Fax:609-278-6878
Practice Address - Street 1:1251 LAWRENCE RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3545
Practice Address - Country:US
Practice Address - Phone:609-882-7777
Practice Address - Fax:609-530-1475
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI020987000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist