Healthcare Provider Details

I. General information

NPI: 1952922791
Provider Name (Legal Business Name): MARIA ZAGORAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17304 47TH AVE
FLUSHING NY
11358-3805
US

IV. Provider business mailing address

17304 47TH AVE
FLUSHING NY
11358-3805
US

V. Phone/Fax

Practice location:
  • Phone: 646-236-1241
  • Fax:
Mailing address:
  • Phone: 646-236-1241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: