Individual
MR. NIKITAS NICHOLAIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CSCS, CFST2
Contact information
Practice address
627 E RIDGEWOOD AVE, RIDGEWOOD, NJ 07450-3310
(201) 670-2800
Mailing address
123 HONEYSUCKLE DR, TOWNSHIP OF WASHINGTON, NJ 07676-5263
(201) 664-1010
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00084300
NJ
Other
Enumeration date
05/07/2007
Last updated
11/02/2011
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