Individual
MISS NICHOLE KIELTYKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
65 SIWANOY BLVD, EASTCHESTER, NY 10709-3841
(914) 337-6600
Mailing address
65 SIWANOY BLVD, EASTCHESTER, NY 10709-3841
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001563-1
NY
Other
Enumeration date
10/28/2011
Last updated
01/25/2016
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