Eleni Georgiadis, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

004216 Issued in NY

Practice address

6802 Metropolitan Ave
Middle Village, NY 11379-1622

Phone

(718) 366-7400

NPI assigned

Nov 2, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1962167239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 CLINTONVILLE ST",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 METROPOLITAN AVE",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791622",
            "telephone_number": "718-366-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 E Main St",
            "address_purpose": "LOCATION",
            "city": "Oyster Bay",
            "state": "NY",
            "postal_code": "117712402",
            "country_code": "US",
            "telephone_number": "516-624-6523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGIADIS",
        "first_name": "ELENI",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "004216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Middle Village, NY
• Providers in Middle Village, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.