Provider Demographics
NPI:1447793831
Name:STAMOS, DEBBIE
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:
Last Name:STAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DESPOINA
Other - Middle Name:D
Other - Last Name:GIALLIAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3636 10TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-5112
Mailing Address - Country:US
Mailing Address - Phone:718-361-7464
Mailing Address - Fax:718-361-8014
Practice Address - Street 1:3636 10TH ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-5112
Practice Address - Country:US
Practice Address - Phone:718-361-7464
Practice Address - Fax:718-361-8014
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351527031235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist