Provider Demographics
NPI:1093953697
Name:SPYLIOPULOS, DEBORAH ANNE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANNE
Last Name:SPYLIOPULOS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:ANNE
Other - Last Name:POLANSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:06/14/1980
Mailing Address - Street 1:245 BEACH 77TH ST
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1269
Mailing Address - Country:US
Mailing Address - Phone:347-926-4318
Mailing Address - Fax:
Practice Address - Street 1:245 BEACH 77TH ST
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1269
Practice Address - Country:US
Practice Address - Phone:347-926-4318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6161700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist