Individual
SUSAN NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1300 YORK AVE, LC-423, NEW YORK, NY 10065-4805
(609) 647-7088
Mailing address
123 SANDY RIDGE RD, STOCKTON, NJ 08559-1513
(609) 647-7088
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
197494
NY
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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