Individual
CONSTANTINA GIANNOUTSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
15114 19TH AVE, WHITESTONE, NY 11357-3104
(718) 746-4534
Mailing address
15114 19TH AVE, WHITESTONE, NY 11357-3104
(718) 746-4534
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
038690
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038690
PHARMACY LICENSE
NY
Enumeration date
01/22/2008
Last updated
01/22/2008
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