NPI 1003027459

Martin Haynes Nicol, PAC

Practitioner Physician Assistant New York, NY

Practice location

Address: 2367-69 2nd Ave, New York, NY 10035-3108
Phone: (212) 876-2300
Fax: (212) 369-8209
Mailing address: 145 Remsen Ave, Brooklyn, NY 11212-1342

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 003345-1 (NY)

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Registry record

NPI: 1003027459
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 May 2007
Record last updated: 18 Jul 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.