Individual
NICOLA STEPANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4453 CASTOR AVE, STE B, PHILADELPHIA, PA 19124-3846
(215) 744-2266
(215) 743-9247
Mailing address
4453 CASTOR AVE, STE B, PHILADELPHIA, PA 19124-3846
(215) 744-2266
(215) 743-9247
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS015570
PA
207RN0300X
Nephrology Physician
Primary
OS015570
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037276
MLHC MEDICARE AA #
PA
Enumeration date
07/14/2010
Last updated
04/25/2018
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