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General NPI Number Information
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NPI Number | 1932652518
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Entity Type | Organization
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Legal Business Name | NICHOLAS CENTER
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Dates
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Enumeration Date | 07/29/2016
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Last Update Date | 07/29/2016
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Provider Practice Location Address
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Address Line | 382 MAIN ST SUITE 205
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3181
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Country | US
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Telephone | 516-767-7177
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Fax |
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Provider Business Mailing Address
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Address Line | 382 MAIN ST SUITE 205
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3181
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Country | US
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Telephone | 516-767-7177
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR, CO-FOUNDER
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Name | MS. NICOLE T SUGRUE
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Credential |
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Telephone | 516-767-7177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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