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Individual

MARIA K NICKOLOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
85 BRYANT WOODS S, AMHERST, NY 14228-3604
(716) 689-3333
(716) 689-9866
Mailing address
85 BRYANT WOODS S, AMHERST, NY 14228-3604
(716) 689-3333
(716) 689-9866

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
176758
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010127103
UNIVERA
NY
01
000510644006
HEALTH INTEGRATED
NY
05
01136552
NY
01
11123758
CAQH
NY
01
145074
VALUE OPTIONS
NY
01
1506150
INDEPENDENT HEALTH
NY
Enumeration date
05/24/2005
Last updated
07/08/2007
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