Individual
KALLIOPI K NESTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-9300
Mailing address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD429725
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1906113
BLUE SHIELD
PA
01
—
MD429725
LICENSE NUMBER
PA
Enumeration date
08/22/2006
Last updated
04/10/2008
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