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General NPI Number Information
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NPI Number | 1639274905
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Entity Type | Organization
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Legal Business Name | DANIEL I MCNICHOL MD INC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 300 MAIN ST
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City | VESTAL
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State | NY
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Zip | 13850-1545
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Country | US
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Telephone | 607-786-9522
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Fax |
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Provider Business Mailing Address
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Address Line | 300 MAIN ST
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City | VESTAL
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State | NY
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Zip | 13850-1545
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Country | US
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Telephone | 607-786-9522
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DANIEL MCNICHOL
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Credential | MD
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Telephone | 607-786-9522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 148662
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License Number State | NY
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