Provider Demographics
NPI:1568773794
Name:ZIAVRAS, GIANOULA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GIANOULA
Middle Name:
Last Name:ZIAVRAS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2391 BELL BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2000
Mailing Address - Country:US
Mailing Address - Phone:718-943-6202
Mailing Address - Fax:718-943-6204
Practice Address - Street 1:2391 BELL BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2000
Practice Address - Country:US
Practice Address - Phone:718-943-6202
Practice Address - Fax:718-943-6204
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015674-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist