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General NPI Number Information
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NPI Number | 1043421381
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Entity Type | Individual
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Provider Name | NICOLA BECKLES PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 221 BROADWAY SUITE 201C
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City | AMITYVILLE
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State | NY
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Zip | 11701-2780
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Country | US
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Telephone | 718-390-8815
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Fax | 718-526-5503
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Provider Business Mailing Address
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Address Line | PO BOX 85
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City | AMITYVILLE
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State | NY
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Zip | 11701-0085
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Country | US
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Telephone | 718-390-8815
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Fax | 718-526-5503
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 009984
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License Number State | NY
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