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NPI Code Detail

MEDICARE: NICOLLE FINN PA-C

MEDICARE: NICOLLE FINN PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1376026948
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLLE FINN PA-C
Provider Business Mailing Address
First Line : 21 W 19TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10011-4208
Country : US
Telephone Number : 646-665-3632
Fax Number :
Provider Business Practice Location Address
First Line : 2701 QUEENS PLZ N FL 10
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-4022
Country : US
Telephone Number : 203-996-6379
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2018
Last Update Date : 08/20/2019

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