Individual
DR. NEIL SCOTT NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 SUFFOLK AVE, BRENTWOOD, NY 11717-4309
(855) 295-4144
(631) 257-5098
Mailing address
125 KENNEDY DR STE 400, HAUPPAUGE, NY 11788-4017
(855) 295-4144
(631) 257-5098
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
244448
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03038497
—
NY
Enumeration date
04/10/2007
Last updated
01/29/2021
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