Provider Demographics
NPI:1578855235
Name:NIKCI, VALDET
Entity Type:Individual
Prefix:
First Name:VALDET
Middle Name:
Last Name:NIKCI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 OLD NEW MILFORD RD STE 3E
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2414
Mailing Address - Country:US
Mailing Address - Phone:203-775-6205
Mailing Address - Fax:203-775-2373
Practice Address - Street 1:60 OLD NEW MILFORD RD STE 3E
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2414
Practice Address - Country:US
Practice Address - Phone:203-775-6205
Practice Address - Fax:203-775-2373
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284742207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty