Nichols, Constance G.

Nichols, Constance G. is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Clinical Informatics. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Nichols, Constance G. can be contacted via phone (508) 421-1400.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655
Fax: (508) 421-1490
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 55749 Massachusetts
Allopathic & Osteopathic Physicians / Clinical Informatics 2083C0008X 55749 Massachusetts

Profile Details

NPI number 1619952264
LBN Legal business name Nichols, Constance G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated May 17th, 2018 - about 6 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 1619952264 NPPES
Massachusetts MEDICAID 110042960A

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