Provider Demographics
NPI:1790937522
Name:CHRISTOFOROU-GIOULES, IRENE (PHD)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:CHRISTOFOROU-GIOULES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15050 14TH RD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2607
Mailing Address - Country:US
Mailing Address - Phone:718-767-0091
Mailing Address - Fax:718-767-0086
Practice Address - Street 1:15050 14TH RD
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-2607
Practice Address - Country:US
Practice Address - Phone:718-767-0091
Practice Address - Fax:718-767-0086
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0120123235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG40002707OtherPTAN