Provider Demographics
NPI:1356446017
Name:SIDIROPOULOS, NIKOLETTA (MD)
Entity Type:Individual
Prefix:
First Name:NIKOLETTA
Middle Name:
Last Name:SIDIROPOULOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-356-7323
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-356-7323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0011781207SM0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SM0001XAllopathic & Osteopathic PhysiciansMedical GeneticsMolecular Genetic Pathology