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NPI Code Detail

MEDICARE: STEVE NICKELSBERG

MEDICARE:   STEVE  NICKELSBERG
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
1156FX1800XOpticianNJ1504NJ

General Provider Information

NPI Number : 1659411536
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVE NICKELSBERG
Provider Business Mailing Address
First Line : 752 ASBURY AVE
Second Line :
City : OCEAN CITY
State : NJ
Zip : 08226-3721
Country : US
Telephone Number : 609-391-2121
Fax Number :
Provider Business Practice Location Address
First Line : 752 ASBURY AVE
Second Line :
City : OCEAN CITY
State : NJ
Zip : 08226-3721
Country : US
Telephone Number : 609-391-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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Directions to “ STEVE NICKELSBERG ” Practice Location

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