Theodora Theodosiadou

NPI #1194087700 in Flushing, New York

Provider Information

NPI Number: 1194087700
Entity Type: Individual
Name: Theodora Theodosiadou
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Jun 10, 2012
Last Updated: Jun 10, 2012

Practice Location

Address: 4515 172ND ST
City: Flushing
State: New York
ZIP Code: 11358-3335
Phone: (917) 868-6585

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary
Early Intervention Provider Agency	252Y00000X

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