Provider Demographics
NPI:1558142406
Name:KATARTZIS, JULIA ANASTASIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANASTASIA
Last Name:KATARTZIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-2241
Mailing Address - Country:US
Mailing Address - Phone:516-754-9109
Mailing Address - Fax:
Practice Address - Street 1:3408 PARK AVE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3702
Practice Address - Country:US
Practice Address - Phone:516-221-2123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
NYP124491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health