Individual
NICKIE JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
2111 WASHINGTON BLVD, EASTON, PA 18042-3803
(610) 253-9617
(610) 253-6705
Mailing address
2111 WASHINGTON BLVD, EASTON, PA 18042-3803
(610) 253-9617
(610) 253-6705
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC005889
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014105520001
—
PA
Enumeration date
02/02/2006
Last updated
12/15/2009
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