Nickels, Mark
Nickels, Mark is an individual health care provider with primary practice located at 300 Crittenden Blvd , Rochester NY 14642-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Nickels, Mark can be contacted via phone (585) 275-6733.Contact Information
Primary practice address
300 Crittenden Blvd
Rochester NY 14642-0001
Phone: (585) 275-6733
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 155328 | New York |
Profile Details
| NPI number | 1417990748 |
|---|---|
| LBN Legal business name | Nickels, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Jun 29th, 2023 - about last year |
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 | 1417990748 | NPPES |
| New York | MEDICAID | 01639550 |
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