Provider Demographics
NPI:1548563521
Name:NIKOLAIDES, PANAGIOTES (DPT)
Entity Type:Individual
Prefix:DR
First Name:PANAGIOTES
Middle Name:
Last Name:NIKOLAIDES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 SKYLINE CURV
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-3307
Mailing Address - Country:US
Mailing Address - Phone:612-237-0998
Mailing Address - Fax:
Practice Address - Street 1:11133 O STREET
Practice Address - Street 2:TRIAGE STAFFING
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137
Practice Address - Country:US
Practice Address - Phone:800-259-9897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8279225100000X
MN8282225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist