Organization
NICO PA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK N NICOLOFF (SOLE PROPRIETER)
(917) 388-7644
Entity
Organization
Contact information
Practice address
14 KIRKWOOD RD, 2ND FLOOR, PORT WASHINGTON, NY 11050-1437
(917) 388-7644
Mailing address
127 S BROADWAY, YONKERS, NY 10701-4006
(917) 388-7644
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
009001
NY
Other
Enumeration date
01/08/2008
Last updated
01/08/2008
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