Individual
DR. CORAL D. NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1316 BLACK RIVER BLVD N, ROME, NY 13440-3601
(315) 336-3353
(315) 336-3356
Mailing address
1316 BLACK RIVER BLVD N, ROME, NY 13440-3601
(315) 336-3353
(315) 336-3356
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
203978-1
NY
208D00000X
General Practice Physician
Primary
203978-1
NY
Other
Enumeration date
01/30/2006
Last updated
08/30/2012
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