Organization
NICOLE HARRIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE HARRIS (LICENSED PRACTICAL NURSE)
(315) 945-0474
Entity
Organization
Contact information
Practice address
132 WILLOW AVENUE, NEWARK, NY 14513
(315) 945-0474
Mailing address
132 WILLOW AVENEUE, NEWARK, NY 14513
(315) 945-0474
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
691244271
NY
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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