Individual
MATTHEW THOMAS HICKLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
6 WELLNESS WAY STE 101, LATHAM, NY 12110-2156
(518) 782-7733
(518) 782-0800
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382896
NY
Other
Enumeration date
08/24/2018
Last updated
02/12/2024
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