Nicholson, John D

Nicholson, John D is an individual health care provider with primary practice located at Glacier Creek Office Park- Bldg Ii 6711 Towpath Rd., Suite 175, East Syracuse NY 13057-9510. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Nicholson, John D can be contacted via phone (315) 458-2211.

Contact Information

Primary practice address
Glacier Creek Office Park- Bldg Ii 6711 Towpath Rd., Suite 175 East Syracuse NY 13057-9510
Phone: (315) 458-2211
Fax: (315) 452-9025
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 133705 New York
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 133705 New York

Profile Details

NPI number 1699872101
LBN Legal business name Nicholson, John D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2006
Last updated Dec 13th, 2023 - about 3 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 1699872101 NPPES
New York MEDICAID 00456919

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