Individual
DR. ALEXIS NICHEPORUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-8313
Mailing address
66 RANDOLPH PL, WEST ORANGE, NJ 07052-4853
(973) 900-1280
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD491302
PA
Other
Enumeration date
04/27/2020
Last updated
09/08/2025
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