Individual
ELIZABETH ELLEN NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-4363
(315) 464-8690
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-4363
(315) 464-8690
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101249441
VA
207P00000X
Emergency Medicine Physician
Primary
270884
NY
207P00000X
Emergency Medicine Physician
MD438784
PA
Other
Enumeration date
11/26/2008
Last updated
11/21/2013
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