Individual
DOMINIQUE NICOLICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210-26 FRANKLIN AVENUE, FRANKLIN SQUARE, NY 11010
(516) 660-7848
Mailing address
210-26 FRANKLIN AVENUE, FRANKLIN SQUARE, NY 11010
(516) 660-7848
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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