Provider Demographics
NPI:1396067641
Name:EXARHOS, NIKOLAOS (RPH)
Entity type:Individual
Prefix:MR
First Name:NIKOLAOS
Middle Name:
Last Name:EXARHOS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142-02 ROCKAWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11436-1402
Mailing Address - Country:US
Mailing Address - Phone:718-323-8377
Mailing Address - Fax:718-323-9377
Practice Address - Street 1:142-02 ROCKAWAY BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11436
Practice Address - Country:US
Practice Address - Phone:718-323-8377
Practice Address - Fax:718-323-9377
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049927183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist