Provider Demographics
NPI:1104109420
Name:PARTHENIS-ANAGNOSTOPOULOS, KALLY (MS)
Entity type:Individual
Prefix:MRS
First Name:KALLY
Middle Name:
Last Name:PARTHENIS-ANAGNOSTOPOULOS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 160TH ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3215
Mailing Address - Country:US
Mailing Address - Phone:917-767-1887
Mailing Address - Fax:718-939-0306
Practice Address - Street 1:2532 168TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1154
Practice Address - Country:US
Practice Address - Phone:718-939-0306
Practice Address - Fax:718-939-0306
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist