Individual
DMITRIY NIKOLAVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-6106
(315) 464-6117
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-6106
(315) 464-6117
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301086420
MI
208800000X
Urology Physician
Primary
265866
NY
208800000X
Urology Physician
49881
CO
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
265866
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03480646
—
NY
Enumeration date
05/14/2007
Last updated
08/27/2013
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