Conklin, Nicole

Conklin, Nicole is an individual health care provider with primary practice located at 38 Schuyler Dr , Commack NY 11725-4019. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Conklin, Nicole can be contacted via phone (631) 418-7771.

Contact Information

Primary practice address
38 Schuyler Dr Commack NY 11725-4019
Phone: (631) 418-7771
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1740724921
LBN Legal business name Conklin, Nicole
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2016
Last updated Dec 7th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740724921 NPPES
New York MEDICAID AFK21089C01

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