Healthcare Provider Details

I. General information

NPI: 1811382468
Provider Name (Legal Business Name): EKATERINI STIPONIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1066 RUSSELL ST
FRANKLIN SQUARE NY
11010-2604
US

IV. Provider business mailing address

1066 RUSSELL ST
FRANKLIN SQUARE NY
11010-2604
US

V. Phone/Fax

Practice location:
  • Phone: 646-546-8063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number004600
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: