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NPI Code Detail

MEDICARE: DR. CHRISTOPHER JAMES NICKERSON MD

MEDICARE:  DR. CHRISTOPHER JAMES NICKERSON  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician141740NY
2207R00000XInternal Medicine Physician25MA04997500NJ

General Provider Information

NPI Number : 1194872325
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER JAMES NICKERSON MD
Provider Business Mailing Address
First Line : 1345 RXR PLZ
Second Line :
City : UNIONDALE
State : NY
Zip : 11556-1301
Country : US
Telephone Number : 516-783-4600
Fax Number :
Provider Business Practice Location Address
First Line : 231 WASHINGTON ST
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-4738
Country : US
Telephone Number : 201-754-1005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/22/2019

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Directions to “ DR. CHRISTOPHER JAMES NICKERSON MD” Practice Location

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