Provider Demographics
NPI:1508109950
Name:MIKOU, AMINE (RN)
Entity Type:Individual
Prefix:MR
First Name:AMINE
Middle Name:
Last Name:MIKOU
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2246 43RD ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1426
Mailing Address - Country:US
Mailing Address - Phone:646-403-6981
Mailing Address - Fax:
Practice Address - Street 1:2246 43RD ST
Practice Address - Street 2:APT. 1
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-1426
Practice Address - Country:US
Practice Address - Phone:646-403-6981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY666311-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse