Provider Demographics
NPI:1013948272
Name:EFTHIMIOU, JOELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOELLE
Middle Name:
Last Name:EFTHIMIOU
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 1:1 NORWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-3620
Mailing Address - Country:US
Mailing Address - Phone:631-252-2430
Mailing Address - Fax:
Practice Address - Street 1:1 NORWOOD RD
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-3620
Practice Address - Country:US
Practice Address - Phone:631-252-2430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012465-1103TC1900X
NY012465103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling