Individual
DR. CARL A NICOLEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
2008 SEAGIRT BLVD, FAR ROCKAWAY, NY 11691-2803
(718) 565-6880
(877) 796-4457
Mailing address
2008 SEAGIRT BLVD, FAR ROCKAWAY, NY 11691-2803
(718) 565-6880
(877) 796-4457
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
180270
NY
207RS0012X
Sleep Medicine (Internal Medicine) Physician
141096
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01454842
—
NY
01
—
180270
STATE LICENSE
NY
Enumeration date
05/28/2006
Last updated
08/26/2024
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