MEDICARE: CHRISTINA KARKOUTA MS, CCC-SLP, TSSLD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	023124	NY

General Provider Information

NPI Number	:	1861935694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA KARKOUTA MS, CCC-SLP, TSSLD

Provider Business Mailing Address
First Line	:	318 E OLIVE ST
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3616
Country	:	US
Telephone Number	:	718-749-4713
Fax Number	:

Provider Business Practice Location Address
First Line	:	4105 FARRAGUT RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2009
Country	:	US
Telephone Number	:	718-292-4920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2016
Last Update Date	:	11/28/2016

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Directions to “ CHRISTINA KARKOUTA MS, CCC-SLP, TSSLD” Practice Location

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