Provider Demographics
NPI:1538181417
Name:ALIKOR MPI, CATHERINE NDAALU (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:NDAALU
Last Name:ALIKOR MPI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:NDAALU
Other - Last Name:ALIKOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:914 DANA AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1309
Mailing Address - Country:US
Mailing Address - Phone:718-523-2727
Mailing Address - Fax:718-206-3059
Practice Address - Street 1:8918 134TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2819
Practice Address - Country:US
Practice Address - Phone:718-523-2727
Practice Address - Fax:718-206-3059
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01237778Medicaid
NYF15960Medicare UPIN
NY02698Medicare ID - Type Unspecified