Individual
DR. KATHERINE GRACE NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
161 FT WASHINGTN AVE, ROOM 218, NEW YORK, NY 10032-3729
(212) 305-4308
(212) 304-6610
Mailing address
161 FT WASHINGTN AVE, ROOM 218, NEW YORK, NY 10032-3729
(212) 305-4308
(212) 304-6610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
157790
NY
207RR0500X
Rheumatology Physician
Primary
157790
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01021407
—
NY
Enumeration date
11/30/2006
Last updated
10/13/2014
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