Provider Demographics
NPI:1255547535
Name:PALOUMBIS, HARRY A (RPH)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:A
Last Name:PALOUMBIS
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 1:1222 81ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3004
Mailing Address - Country:US
Mailing Address - Phone:718-238-1421
Mailing Address - Fax:
Practice Address - Street 1:2201 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6203
Practice Address - Country:US
Practice Address - Phone:212-877-3480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist