Provider Demographics
NPI:1164857405
Name:NIKITEAS, LINDA FAYE
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:FAYE
Last Name:NIKITEAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 VENESS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-4015
Mailing Address - Country:US
Mailing Address - Phone:585-957-1008
Mailing Address - Fax:
Practice Address - Street 1:11 VENESS AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-4015
Practice Address - Country:US
Practice Address - Phone:585-957-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3058651164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse