Provider Demographics
NPI:1073041513
Name:DIOUFA, NIKOLINA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:NIKOLINA
Middle Name:
Last Name:DIOUFA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 N BROAD ST STE 840
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-5104
Mailing Address - Country:US
Mailing Address - Phone:215-707-8995
Mailing Address - Fax:215-707-2738
Practice Address - Street 1:3400 N BROAD ST STE 840
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5104
Practice Address - Country:US
Practice Address - Phone:215-707-8995
Practice Address - Fax:215-707-2738
Is Sole Proprietor?:No
Enumeration Date:2017-05-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT213100207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology