Provider Demographics
NPI:1114288016
Name:GAROUTSOS, IRENE P (SPED TEACHER)
Entity Type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:P
Last Name:GAROUTSOS
Suffix:
Gender:F
Credentials:SPED TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20902 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-1423
Mailing Address - Country:US
Mailing Address - Phone:347-738-2338
Mailing Address - Fax:
Practice Address - Street 1:20902 34TH AVE
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-1423
Practice Address - Country:US
Practice Address - Phone:347-738-2338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist