Individual
MIKHAIL VLADIMIR NICKITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1430 BROADWAY, SUITE 1608, NEW YORK, NY 10018
(212) 730-7777
(212) 730-7797
Mailing address
42 GRANDVIEW CIRCLE, MANHASSET, NY 11030
(212) 730-7777
(212) 730-7797
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
223957
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02365433
—
NY
Enumeration date
01/12/2007
Last updated
07/08/2007
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