Individual
DR. BRIAN WALRATH NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 MARCUS AVE STE 108, NEW HYDE PARK, NY 11042-1113
(516) 622-7400
Mailing address
2800 MARCUS AVE STE 108, NEW HYDE PARK, NY 11042-1113
(516) 622-7400
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
254112
MA
207LP3000X
Pediatric Anesthesiology Physician
Primary
262969
NY
Other
Enumeration date
05/07/2009
Last updated
05/28/2020
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