Individual
ASHLEY G NICHOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. PA-C; CCC-SLP
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2500
Mailing address
24 SEA SPRAY DR, CENTERPORT, NY 11721-1633
(631) 513-6554
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
022439-1
NY
363A00000X
Physician Assistant
Primary
023317
NY
Other
Enumeration date
05/13/2013
Last updated
06/18/2019
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