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General NPI Number Information
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NPI Number | 1164869145
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Entity Type | Individual
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Provider Name | JO ANN NICHOLAS ED.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 87 CHERRY LN
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City | AIRMONT
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State | NY
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Zip | 10952-4301
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Country | US
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Telephone | 845-357-6225
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Fax |
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Provider Business Mailing Address
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Address Line | 525 W 120TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-6605
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Country | US
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Telephone | 212-678-3408
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Fax | 212-678-8233
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 000535-1
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License Number State | NY
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