Provider Demographics
NPI:1588994529
Name:ANDREADIS, KATHERINE STELLA (MA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:STELLA
Last Name:ANDREADIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 145TH PL
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3017
Mailing Address - Country:US
Mailing Address - Phone:718-746-6895
Mailing Address - Fax:
Practice Address - Street 1:1501 145TH PL
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3017
Practice Address - Country:US
Practice Address - Phone:718-746-6895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002239231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist