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MR. CLIFFORD NEIL NICKERSON III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
2250 WEHRLE DR, WILLIAMSVILLE, NY 14221-7034
(716) 276-2123
Mailing address
2250 WEHRLE DR, WILLIAMSVILLE, NY 14221-7034
(716) 276-2123

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
331437-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
331437-1
NY
Enumeration date
10/20/2020
Last updated
10/20/2020
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