Individual
NICOLE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 BUXTON FARM RD STE 230, STAMFORD, CT 06905-1206
(203) 914-1900
Mailing address
30 BUXTON FARM RD STE 230, STAMFORD, CT 06905-1206
(203) 914-1900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F09230122
CT
2084N0400X
Neurology Physician
12484
CT
Other
Enumeration date
09/14/2023
Last updated
07/02/2024
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