Individual
EVANGELIA K NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
506 6TH ST, NY METHODIST HOSPITAL, BROOKLYN, NY 11215
(718) 780-3279
(845) 790-2613
Mailing address
PO BOX 550, 2 CATHARINE ST PARK SLOPE ANESTHESIA ASSOC, PC, POUGHKEEPSIE, NY 12602
(845) 790-2614
(845) 790-2313
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
216488-1
NY
207L00000X
Anesthesiology Physician
25MA08256700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216488
NY LICENSE
NY
01
—
25MA08256700
LICENSE
NJ
Enumeration date
12/31/2012
Last updated
03/25/2015
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