Individual
MR. ALEXANDER ELY NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NPP
Contact information
Practice address
711 TROY SCHENECTADY RD STE 202, LATHAM, NY 12110-2461
(518) 782-3703
(518) 782-3809
Mailing address
711 TROY SCHENECTADY RD STE 202, LATHAM, NY 12110-2461
(518) 782-3703
(518) 782-3809
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401487-1
NY
Other
Enumeration date
07/08/2012
Last updated
07/21/2022
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