Provider Demographics
NPI:1689825994
Name:NIKOLIC, JANET E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:E
Last Name:NIKOLIC
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-0428
Mailing Address - Country:US
Mailing Address - Phone:732-541-6521
Mailing Address - Fax:
Practice Address - Street 1:606 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-2935
Practice Address - Country:US
Practice Address - Phone:732-541-6521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00140700363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical