Individual provider Active NPI

Evangelo Zissis, PHARMD.

  • Pharmacist
  • Glen Head, NY
National Provider Identifier
1669794194
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
054099 Issued in NY
Practice address
20 Elin PL
Glen Head, NY 11545-1010
Phone
(914) 703-1822
NPI assigned
Feb 25, 2010
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 054099 NY Primary

Addresses

Primary practice location

20 Elin PL
Glen Head, NY 11545-1010

Mailing address

20 Elin PL
Glen Head, NY 11545-1010
Phone (914) 703-1822

Other names 1

  • Angelo Zissis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
054099NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bryant Chemists Inc CurrentSince Nov 8, 2025 Accepting new patients
Vitahealth Apothecary PastSince Oct 2, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1669794194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ELIN PL",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451010",
            "telephone_number": "914-703-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ELIN PL",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451010",
            "telephone_number": "914-703-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZISSIS",
        "first_name": "EVANGELO",
        "name_prefix": "Mr.",
        "credential": "PHARMD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-25",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "054099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELO",
            "last_name": "ZISSIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Head, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.