Provider Demographics
NPI:1194903807
Name:ECONOMOU, THOMAS ANDREAS (PHARM D)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANDREAS
Last Name:ECONOMOU
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-5435
Mailing Address - Country:US
Mailing Address - Phone:631-547-5029
Mailing Address - Fax:631-547-6757
Practice Address - Street 1:1100 EAST JERICHO TURNPIKE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-5435
Practice Address - Country:US
Practice Address - Phone:631-547-5029
Practice Address - Fax:631-547-6757
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist