Provider Demographics
NPI:1972631158
Name:KYRIANNIS, ELENI
Entity Type:Individual
Prefix:MS
First Name:ELENI
Middle Name:
Last Name:KYRIANNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 23RD ST
Mailing Address - Street 2:APT 3A
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4100
Mailing Address - Country:US
Mailing Address - Phone:914-723-4900
Mailing Address - Fax:914-723-7893
Practice Address - Street 1:1075 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3242
Practice Address - Country:US
Practice Address - Phone:914-723-4900
Practice Address - Fax:914-723-7893
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0133701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q01P61OtherEMPIRE BLUE CROSS