Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 81692 | GA |
N | 207RH0003X | Hematology & Oncology | 81692 | GA |
NPI | 1457827214 |
---|---|
Provider Name | Dr. Nicki Panoskaltsis |
First Address | Atlanta, GA 30305-1387 |
Second Address | Atlanta, GA 30322-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2018 |
Last Update Date | 19/10/2018 |