Individual
ALLEN DANIEL NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 HOWARD AVE, YBP 133, YNHH DEPT OF ORTHOPEDICS, NEW HAVEN, CT 06519-1369
(203) 785-2579
Mailing address
776 SHREWSBURY AVE STE 201, TINTON FALLS, NJ 07724-4507
(732) 530-4949
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25MA11115400
NJ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
301928
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2015
Last updated
08/12/2021
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