Provider Demographics
NPI:1598208472
Name:ZOURNATZOGLOU, ELENI (SLP)
Entity Type:Individual
Prefix:
First Name:ELENI
Middle Name:
Last Name:ZOURNATZOGLOU
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1121
Mailing Address - Country:US
Mailing Address - Phone:718-728-1459
Mailing Address - Fax:
Practice Address - Street 1:7510 21ST AVE
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1121
Practice Address - Country:US
Practice Address - Phone:718-728-1459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019681-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist