Divaris, Nicholas
Divaris, Nicholas is an individual health care provider with primary practice located at 14 Technology Dr , East Setauket NY 11733-3472. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Trauma, which is considered as his primary health care specialty. Divaris, Nicholas can be contacted via phone (631) 444-4233.Contact Information
Primary practice address
14 Technology Dr
East Setauket NY 11733-3472
Phone: (631) 444-4233
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Trauma | 207XX0801X | 207388 | New York |
Profile Details
| NPI number | 1023065380 |
|---|---|
| LBN Legal business name | Divaris, Nicholas |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023065380 | NPPES |
| New York | Other | 7470302 | AETNA |
| New York | MEDICAID | 02176736 | AETNA |
| New York | Other | 421G01 | AETNA |
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