Active NPI
Theresa Victoria Georgiou
- Speech-Language Pathologist
- Rego Park, NY
National Provider Identifier
1215660790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 61-21 97TH Place
Rego Park, NY 11374 - Phone
- (718) 592-0300
- NPI assigned
- Jul 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | NY | Primary |
Addresses
Primary practice location
61-21 97TH Place
Rego Park, NY 11374
Mailing address
717 Willis Ave Apt 4a
Williston Park, NY 11596-1112
Phone (917) 881-3505
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767571200000",
"number": "1215660790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 WILLIS AVE APT 4A",
"city": "WILLISTON PARK",
"state": "NY",
"postal_code": "115961112",
"telephone_number": "917-881-3505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61-21 97TH PLACE",
"city": "REGO PARK",
"state": "NY",
"postal_code": "11374",
"telephone_number": "718-592-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGIOU",
"first_name": "THERESA",
"middle_name": "VICTORIA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-02",
"last_updated": "2026-01-05",
"certification_date": "2026-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.