Basic Information
| Provider Information | |||||||||
| NPI: | 1548563521 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NIKOLAIDES | ||||||||
| FirstName: | PANAGIOTES | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 SKYLINE CURV | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554113307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122370998 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11133 O STREET | ||||||||
| Address2: | TRIAGE STAFFING | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002599897 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2010 | ||||||||
| LastUpdateDate: | 12/13/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 8279 | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 8282 | MN | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.