Provider Demographics
NPI:1972632420
Name:NIKA MEDICAL, P.C.
Entity type:Organization
Organization Name:NIKA MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMASHOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1917-836-5296
Mailing Address - Street 1:55 MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2427
Mailing Address - Country:US
Mailing Address - Phone:718-667-7778
Mailing Address - Fax:718-317-7014
Practice Address - Street 1:55 MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2427
Practice Address - Country:US
Practice Address - Phone:718-667-7778
Practice Address - Fax:718-317-7014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240566261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care