Active NPI
Theoni Stavrianopoulos
- Speech-Language Pathologist
- Rego Park, NY
National Provider Identifier
1871846675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 022057
- Practice address
- 9777 Queens Blvd
Rego Park, NY 11374-3335 - Phone
- (718) 830-9274
- NPI assigned
- Oct 18, 2012
- 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 | 022057 | NY | Primary |
Addresses
Primary practice location
9777 Queens Blvd
Rego Park, NY 11374-3335
Mailing address
9777 Queens Blvd
Rego Park, NY 11374-3335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871846675 | Other | NPI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022057 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392336000000",
"number": "1871846675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9777 QUEENS BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113743335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9777 QUEENS BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113743335",
"telephone_number": "718-830-9274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAVRIANOPOULOS",
"first_name": "THEONI",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-18",
"last_updated": "2014-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "022057",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1871846675",
"state": null
}
],
"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 Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.