Individual
CHRISTINA NICOLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
750 EAST ADAMS ST, SYRACUSE, NY 13210
(315) 464-5450
(315) 454-6322
Mailing address
251 SALINA MEADOWS PKWY, STE 100, SYRACUSE, NY 13212-4516
(315) 464-2000
(315) 464-2010
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
023967
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
09/14/2018
Last updated
10/29/2020
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