Provider Demographics
NPI:1902452667
Name:SBIRAKIS, CHRISOULA
Entity Type:Individual
Prefix:
First Name:CHRISOULA
Middle Name:
Last Name:SBIRAKIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157-20 24TH RD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3719
Mailing Address - Country:US
Mailing Address - Phone:347-536-6784
Mailing Address - Fax:
Practice Address - Street 1:132-22 14TH AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356
Practice Address - Country:US
Practice Address - Phone:718-747-1826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist