Provider Demographics
NPI:1578792743
Name:KARANTZOULIS, STELLA (PHD)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:
Last Name:KARANTZOULIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:145 EAST 32ND STREET THE PEARL BARLOW CENTER
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6055
Mailing Address - Country:US
Mailing Address - Phone:212-263-3210
Mailing Address - Fax:212-263-3273
Practice Address - Street 1:145 EAST 32ND STREET THE PEARL BARLOW CENTER
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6055
Practice Address - Country:US
Practice Address - Phone:212-263-3210
Practice Address - Fax:212-263-3273
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017975103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist