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Individual

ANDREA M NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
979 CROSS BRONX EXPY, BRONX, NY 10460-4885
(718) 665-7565
(718) 665-7565
Mailing address
979 CROSS BRONX EXPY, BRONX, NY 10460-4885
(718) 665-7565

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207843
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00695941
NY
Enumeration date
10/26/2006
Last updated
04/10/2024
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