Individual
NICKIE DOUROUDAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2200 NORTHERN BLVD STE 121, GREENVALE, NY 11548-1220
(516) 705-1044
Mailing address
22112 59TH AVE, OAKLAND GARDENS, NY 11364-1930
(917) 453-8024
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
008029
NY
Other
Enumeration date
03/05/2007
Last updated
08/11/2022
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