Individual
MS. NICOLE MARIE GARDOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
389 MERRICK AVE, MERRICK, NY 11566-2723
(516) 867-5132
Mailing address
15 ANITA PL, AMITY HARBOR, NY 11701-4101
(631) 662-1089
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
023060-1
NY
Other
Enumeration date
01/07/2019
Last updated
01/07/2019
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