Individual
ALEXANDER NICOLAIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2318 31ST ST, SUITE 320, ASTORIA, NY 11105-2892
(718) 728-9822
(718) 728-2004
Mailing address
2318 31ST ST, SUITE 320, ASTORIA, NY 11105-2892
(718) 728-9822
(718) 728-2004
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
212075
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07365G
MEDICARE PROVIDER NUMBER
NY
Enumeration date
10/05/2006
Last updated
01/30/2008
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