Provider Demographics
NPI:1235453275
Name:TORLIDAKIS, CONSTANTINE (RPH)
Entity type:Individual
Prefix:MR
First Name:CONSTANTINE
Middle Name:
Last Name:TORLIDAKIS
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 1:137 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3174
Mailing Address - Country:US
Mailing Address - Phone:212-598-9798
Mailing Address - Fax:
Practice Address - Street 1:137 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3174
Practice Address - Country:US
Practice Address - Phone:212-598-9798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist