Provider Demographics
NPI:1790930089
Name:MARKOU-GERASIMOU, VASILIKI (SLP)
Entity Type:Individual
Prefix:
First Name:VASILIKI
Middle Name:
Last Name:MARKOU-GERASIMOU
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 1:1982 78TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1308
Mailing Address - Country:US
Mailing Address - Phone:347-743-8831
Mailing Address - Fax:
Practice Address - Street 1:1982 78TH ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1308
Practice Address - Country:US
Practice Address - Phone:347-743-8831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015304-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist