Individual
JOSHUA NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4641 E ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2343
(800) 889-0548
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6211
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036177295
IL
2084P0800X
Psychiatry Physician
DR.0068432
CO
2084P0800X
Psychiatry Physician
Primary
OS019814
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
05/23/2016
Last updated
11/13/2025
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