Individual
NICHOLAS LEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 W 128TH ST APT 53A, NEW YORK, NY 10027-2858
(646) 409-7579
Mailing address
400 W 128TH ST APT 53A, NEW YORK, NY 10027-2858
(646) 409-7579
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
13886
NV
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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