Provider Demographics
NPI:1154705341
Name:MORAROS, NIKOLAOS
Entity type:Individual
Prefix:
First Name:NIKOLAOS
Middle Name:
Last Name:MORAROS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4591 SOUTHWESTERN BLVD APT T1
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1983
Mailing Address - Country:US
Mailing Address - Phone:716-335-1553
Mailing Address - Fax:
Practice Address - Street 1:4591 SOUTHWESTERN BLVD APT T1
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1983
Practice Address - Country:US
Practice Address - Phone:716-335-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY691559-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse