Individual
NICK NICOLAEV NICOLOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
445 KINGS HWY, BROOKLYN, NY 11223-1780
(718) 676-0111
Mailing address
100 CLAREWOOD DR, APT 4E, HASTINGS ON HUDSON, NY 10706-3652
(917) 388-7644
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009001-1
NY
363AS0400X
Surgical Physician Assistant
009001-1
NY
Other
Enumeration date
04/12/2006
Last updated
05/09/2016
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