Individual
JOHN PERRY NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17403 HORACE HARDING EXPY, FRESH MEADOWS, NY 11365-1527
(718) 670-1695
(516) 437-4167
Mailing address
PO BOX 27842, NEW YORK, NY 10087-7842
(718) 670-1651
(516) 437-4167
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
138577
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00856780
—
NY
Enumeration date
07/06/2006
Last updated
12/15/2010
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