Individual
MS. DESPINA PSYLLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2125 76TH ST, EAST ELMHURST, NY 11370-1202
(347) 596-6700
Mailing address
2334 24TH ST, ASTORIA, NY 11105-3415
(347) 596-6700
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
103K00000X
NY
Other
Enumeration date
11/17/2014
Last updated
06/03/2015
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