Individual
MATTHEW PHILLIP NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1043 FARMINGTON AVE, WEST HARTFORD, CT 06107-2110
(860) 549-2020
Mailing address
1043 FARMINGTON AVE, WEST HARTFORD, CT 06107-2110
(860) 549-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35.138743
OH
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
1.068238
CT
Other
Enumeration date
03/31/2016
Last updated
07/19/2021
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