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General NPI Number Information
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NPI Number | 1639500457
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Entity Type | Individual
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Provider Name | DANIA NICOLAS
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Gender | Female
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Dates
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Enumeration Date | 12/04/2013
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 50 CLINTON ST STE 601
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City | HEMPSTEAD
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State | NY
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Zip | 11550-4282
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Country | US
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Telephone | 516-933-0485
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Fax |
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Provider Business Mailing Address
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Address Line | 11713 220TH ST
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-1608
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Country | US
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Telephone | 347-488-7083
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 297214-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 695117
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License Number State | NY
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