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
1	235Z00000X	Speech-Language Pathologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID 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

Language	Start Address	Practice Location

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