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Individual

ALEXANDER NILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11615 228TH ST, CAMBRIA HEIGHTS, NY 11411-1721
(917) 224-5066
Mailing address
11615 228TH ST, CAMBRIA HEIGHTS, NY 11411-1721

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
256532
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
256532
NY
Enumeration date
08/27/2020
Last updated
08/27/2020
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