# NICHOLAS TRIANTAFILLOU MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477711976
- **Authorized official:** JILLIAN ASCH (MANGER)
- **Authorized official phone:** (516) 825-0221

## Contact information

- **Practice address:** 21305 39TH AVE, BAYSIDE, NY 11361-2044
- **Practice address phone:** (718) 224-1378
- **Practice address fax:** (718) 224-1758
- **Mailing address:** 21305 39TH AVE, BAYSIDE, NY 11361-2044
- **Mailing address phone:** (718) 224-1378
- **Mailing address fax:** (718) 224-1758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 199020 | NY | Yes |

## Other

- **Enumeration date:** 05/30/2008
- **Last updated:** 06/24/2009