Individual provider · Type 1 NPI
Nickie Douroudakis, PA
Medical Physician Assistant · Greenvale, NY
NPI number
1265561435
Active
Practice location
2200 Northern Blvd Ste 121
Greenvale, NY 11548-1220
Mailing address
22112 59th Ave
Oakland Gardens, NY 11364-1930
Other practice locations
- 2510 30th Ave, Long Island City, NY 11102-2448 · (718) 267-4245
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 008029 (NY) |
Medical Physician Assistant: Definition to come...
2 other providers at this address
About NPI 1265561435
Nickie Douroudakis, PA's National Provider Identifier is 1265561435, issued on Mar 5, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Greenvale, NY. The record was last updated on Aug 11, 2022.