Provider Demographics
NPI:1578388328
Name:ERI SLP PLLC
Entity type:Organization
Organization Name:ERI SLP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERI
Authorized Official - Middle Name:TINA
Authorized Official - Last Name:THEOTOKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP TSSLD-BE
Authorized Official - Phone:516-204-2388
Mailing Address - Street 1:2522 71ST ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1411
Mailing Address - Country:US
Mailing Address - Phone:516-204-2388
Mailing Address - Fax:
Practice Address - Street 1:2522 71ST ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1411
Practice Address - Country:US
Practice Address - Phone:516-204-2388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech