Provider Demographics
NPI:1033415104
Name:NICOLAIDES, CATHERINE DAPHNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:DAPHNE
Last Name:NICOLAIDES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:733 E ROUTE 70
Mailing Address - Street 2:BUILDING 2, SUITE 201
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2300
Mailing Address - Country:US
Mailing Address - Phone:856-983-6675
Mailing Address - Fax:856-983-5243
Practice Address - Street 1:733 E ROUTE 70
Practice Address - Street 2:BUILDING 2, SUITE 201
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2300
Practice Address - Country:US
Practice Address - Phone:856-983-6675
Practice Address - Fax:856-983-5243
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
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Provider Licenses
StateLicense IDTaxonomies
NJMA566162080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF98517Medicare UPIN