Diane M Nicholson

NPI #1760757983 in Manorville, New York

Provider Information

NPI Number: 1760757983
Entity Type: Individual
Name: Diane M Nicholson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: Mar 21, 2012
Last Updated: Mar 21, 2012

Practice Location

Address: 5 TEE VIEW CT
City: Manorville
State: New York
ZIP Code: 11949-2939
Phone: (631) 874-3032

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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