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NPI Code Detail

MEDICARE: EKATERINI MANOLIS

MEDICARE:   EKATERINI  MANOLIS
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
1235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447634183
Entity Type Code : Individual
Provider Name (Legal Business Name) : EKATERINI MANOLIS
Provider Business Mailing Address
First Line : 2815 49TH ST
Second Line :
City : ASTORIA
State : NY
Zip : 11103-1241
Country : US
Telephone Number : 646-641-9548
Fax Number :
Provider Business Practice Location Address
First Line : 3107 47TH AVENUE
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101
Country : US
Telephone Number : 718-593-2121
Fax Number : 718-268-2646
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2015
Last Update Date : 07/13/2015

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Directions to “ EKATERINI MANOLIS ” Practice Location

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