Individual
DAVID WILLIAM NICKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1419 SALT SPRINGS RD, SYRACUSE, NY 13214-1301
(315) 445-4100
Mailing address
8249 JUSTIN DR, CLAY, NY 13041-8979
(315) 447-6461
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
030786
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2022
Last updated
01/09/2024
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