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1336760784
ALEXIS NICHEPORUCK
STATEN ISLAND, NY
NPI
1336760784
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-04-27
Last Update Date
2020-04-27
Business Address
DR. ALEXIS NICHEPORUCK MD
475 SEAVIEW AVE
STATEN ISLAND, NY 10305-3436
Phone number: 718-226-8313
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Mailing Address
DR. ALEXIS NICHEPORUCK MD
66 RANDOLPH PL
WEST ORANGE, NJ 07052-4853
Phone number: 973-900-1280
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