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Individual

NICHOLAS TRIANTAFILLOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
21305 39TH AVE, BAYSIDE, NY 11361-2044
(718) 224-1378
Mailing address
21305 39TH AVE, BAYSIDE, NY 11361-2044
(718) 224-1378

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
199020
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01785964
NY
Enumeration date
08/18/2005
Last updated
08/13/2015
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