Individual
MR. CAMERON TYLER NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4823
(212) 606-1000
Mailing address
535 E 70TH ST, NEW YORK, NY 10021-4898
(212) 606-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
02/23/2018
Last updated
04/14/2021
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