| Doctor Name: | BORIS NIKOLIC |
| NPI Number: | 1407869241 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 25MA08083500 |
| Business Practice Address: | 5501 Old York Rd Levy Building Philadelphia, PA - 191413018 |
| Business Phone Number: | 2154566200 |
| Business Fax Number: | 2154568996 |
| Mailing Address: | 101 E Olney Ave, Suite 400 PHILADELPHIA |
| State: | PA |
| Postal Code: | 191202421 |
| Phone Number: | 2154567000 |
| Fax Number: | 2152542599 |
| NPI Enumeration Date: | 08/14/2006 |
| NPI Last Update Date: | 05/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 25MA08083500 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |