Healthcare Provider Details

I. General information

NPI: 1720629736
Provider Name (Legal Business Name): ASPASIA PARASKEVI HOTZOGLOU PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 E 57TH ST STE 1101
NEW YORK NY
10022-2962
US

IV. Provider business mailing address

3011 21ST ST APT 2E
ASTORIA NY
11102-2872
US

V. Phone/Fax

Practice location:
  • Phone: 212-308-2440
  • Fax:
Mailing address:
  • Phone: 646-420-8741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number023340
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: