Provider Demographics
NPI:1952833634
Name:GIALLOURAKIS, ALEXANDRA (ATC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:GIALLOURAKIS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 SANDUNE CT
Mailing Address - Street 2:APARTMENT D
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-2750
Mailing Address - Country:US
Mailing Address - Phone:440-829-1185
Mailing Address - Fax:
Practice Address - Street 1:1 SETON HILL DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1548
Practice Address - Country:US
Practice Address - Phone:724-552-1719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0075222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer