Individual
DR. NIKI PATELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
25 KINNELON RD, KINNELON, NJ 07405-2337
(973) 838-8190
(973) 838-3230
Mailing address
25 KINNELON RD, KINNELON, NJ 07405-2337
(973) 838-8190
(973) 838-3230
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00520400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2K5690
HEALTH NET
NJ
01
—
P00201344
RAILROAD MEDICARE
NJ
Enumeration date
06/14/2007
Last updated
01/05/2010
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