Doctor Name: | MRS. JANET E NIKOLIC |
NPI Number: | 1689825994 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 25MP00140700 |
Business Practice Address: | 606 Roosevelt Ave Carteret, NJ - 070082935 |
Business Phone Number: | 7325416521 |
Business Fax Number: | |
Mailing Address: | Po Box 428, CARTERET |
State: | NJ |
Postal Code: | 070080428 |
Phone Number: | 7325416521 |
Fax Number: | |
NPI Enumeration Date: | 10/06/2008 |
NPI Last Update Date: | 07/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 25MP00140700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |