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Individual

DR. JOEL LAWRENCE NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1444 MASSACHUSETTS AVE, SUITE 103, TROY, NY 12180-1600
(518) 266-1205
(518) 266-1270
Mailing address
1444 MASSACHUSETTS AVE, SUITE 103, TROY, NY 12180-1600
(518) 266-1205
(518) 266-1270

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
056-0000170
VT
213E00000X
Podiatrist
Primary
N005539-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000493808004
BSNENY
NY
05
02133746
NY
01
10031220
CDPHP
NY
01
699362
MVP
NY
01
P00237591
RRMC
NY
Enumeration date
08/27/2006
Last updated
01/26/2011
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