Individual
HORMUZ NICOLWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
240 MEETING HOUSE LN, SOUTHAMPTON, NY 11968-5009
(631) 726-8200
Mailing address
201 W BROADWAY APT 211, PORT JEFFERSON, NY 11777-1352
(979) 777-9411
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
308598
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2015
Last updated
07/21/2021
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