Individual
DR. LARRY THOMAS NICKELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
315 SOUTH MANNING BLVD, ALBANY, NY 12208-6819
(518) 525-1401
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
308425
CO
2085R0202X
Diagnostic Radiology Physician
Primary
308425
NY
2085R0202X
Diagnostic Radiology Physician
DR.0056434
CO
Other
Enumeration date
04/06/2010
Last updated
05/19/2021
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