Individual
NICOS NICOLAOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 PRESIDENTIAL BLVD, SUITE 100, BALA CYNWYD, PA 19004-1017
(610) 632-4100
(610) 668-1004
Mailing address
1 PRESIDENTIAL BLVD, SUITE 100, BALA CYNWYD, PA 19004-1017
(610) 632-4100
(610) 668-1004
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD053676L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016207530002
—
PA
Enumeration date
07/21/2006
Last updated
10/03/2012
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