MEDICARE: NITOL SIKDAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1417582016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NITOL SIKDAR

Provider Business Mailing Address
First Line	:	1730 RADCLIFF AVE PH
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-4021
Country	:	US
Telephone Number	:	646-248-0491
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 RADCLIFF AVE PH
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-4021
Country	:	US
Telephone Number	:	646-248-0491
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2020
Last Update Date	:	03/04/2020

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Directions to “ NITOL SIKDAR ” Practice Location

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