Individual
DR. JAMES NICHOLSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14 TECHNOLOGY DR, EAST SETAUKET, NY 11733-3472
(631) 444-4233
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-4233
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
236798
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02681905
—
NY
01
—
660G31
EMPIRE BC.BS
NY
01
—
7333761
AETNA
NY
Enumeration date
06/08/2006
Last updated
07/08/2007
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