Provider Information for 1669734596
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EDWARD NICHOLS LCSW
Other Names:Former Name:Mr. EDWARD ARBUISO LCSWSex: Male
NPI: 1669734596
Last Updated: 2012-10-11
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1669734596 | ||||||||
| Enumeration Date | 2012-06-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 2141 SIDNEY, NY 13838-2141 United States Phone: 607-563-8707 | Fax:607-563-7099 | ||||||||
| Primary Practice Address | 22 WEIR ST 3RD FLOOR SIDNEY, NY 13838-1022 United States Phone: 607-563-8707 | Fax:607-563-7099 | ||||||||
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