Malcolm, Nickeey Kissian

Malcolm, Nickeey Kissian is an individual health care provider with primary practice located at 820 W Lake Mary Blvd Suite 102, Sanford FL 32773-5946. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Malcolm, Nickeey Kissian can be contacted via phone (407) 955-4445.

Contact Information

Primary practice address
820 W Lake Mary Blvd Suite 102 Sanford FL 32773-5946
Phone: (407) 955-4445
Fax: (407) 955-4446
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X TRN7776 Florida
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME99391 Florida

Profile Details

NPI number 1942380977
LBN Legal business name Malcolm, Nickeey Kissian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Aug 23rd, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942380977 NPPES
Florida MEDICAID 000568000

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