Individual provider · Type 1 NPI

Alexis Nicheporuck, MD

Diagnostic Radiology Physician · Staten Island, NY

NPI number 1336760784 Active

Practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Call (718) 226-8313 Map

Mailing address

66 Randolph Pl
West Orange, NJ 07052-4853

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician Primary 2085R0202XMD491302 (PA)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1336760784

Alexis Nicheporuck, MD's National Provider Identifier is 1336760784, issued on Apr 27, 2020. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Staten Island, NY. The record was last updated on Sep 8, 2025.