Provider Demographics
NPI:1992301253
Name:ELEFTHERIOS, KATHERINE (RPH)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:ELEFTHERIOS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 S LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4327
Mailing Address - Country:US
Mailing Address - Phone:973-992-6854
Mailing Address - Fax:
Practice Address - Street 1:483 S LVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4327
Practice Address - Country:US
Practice Address - Phone:973-992-6854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02307500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist