MR. Richard Jesse Nicholson
NPI #1578740247 in Lake Luzerne, New York
Provider Information
- NPI Number
- 1578740247
- Entity Type
- Individual
- Name
- MR. Richard Jesse Nicholson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Jan 24, 2008
- Last Updated
- Jan 24, 2008
Practice Location
- Address
- 1041 E RIVER DR
- City
- Lake Luzerne
- State
- New York
- ZIP Code
- 12846-2305
- Phone
- (518) 964-6773
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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