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NPI Code Detail

MEDICARE: IRENE ALEXIA CONSTANTINIDIS MS, CCC-SLP, TSSLD

MEDICARE: IRENE ALEXIA CONSTANTINIDIS MS, CCC-SLP, TSSLD
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 Pathologist032504NY

General Provider Information

NPI Number : 1831878016
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENE ALEXIA CONSTANTINIDIS MS, CCC-SLP, TSSLD
Provider Business Mailing Address
First Line : 1 KENNEDY DR
Second Line :
City : PLAINVIEW
State : NY
Zip : 11803-4017
Country : US
Telephone Number : 516-282-6486
Fax Number :
Provider Business Practice Location Address
First Line : 2420 PARSONS BLVD
Second Line :
City : WHITESTONE
State : NY
Zip : 11357-3444
Country : US
Telephone Number : 718-459-6279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2023
Last Update Date : 07/14/2023

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Directions to “ IRENE ALEXIA CONSTANTINIDIS MS, CCC-SLP, TSSLD” Practice Location

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