| Doctor Name: | DR. NICHOLAS KARDARAS |
| NPI Number: | 1255640132 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D., LCSW |
| License Number: | 73-072649 |
| Business Practice Address: | 53480 Main Road Route 25 Suite 1 Southold, NY - 11971 |
| Business Phone Number: | 3475288108 |
| Business Fax Number: | |
| Mailing Address: | 55 Pequash Ave, Po Box 226 CUTCHOGUE |
| State: | NY |
| Postal Code: | 119351447 |
| Phone Number: | 3475288108 |
| Fax Number: | |
| NPI Enumeration Date: | 09/27/2010 |
| NPI Last Update Date: | 09/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 73-072649 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |