Individual
CAROLINE NICOLAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
506 6TH ST, BROOKLYN, NY 11215
(718) 780-5942
Mailing address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-5942
(718) 780-3287
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020906
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1137736
NCCPA
—
Enumeration date
07/26/2017
Last updated
02/06/2019
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