Individual
GREGG NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
Mailing address
67 HAMLET RD, LEVITTOWN, NY 11756-4116
(347) 484-3978
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/19/2025
Last updated
02/20/2025
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