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Contact Information

TIMOTHY NICHOLSON
1184 STATE ROUTE 50
BURNT HILLS, NY12019-1923
 Phone: 518-384-1281
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for TIMOTHY NICHOLSON · (Male)

NPI Number 1013091941
Status Active
Credentials
Entity Individual
Enumeration date 10/25/2006
Last updated 02/08/2013 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 217445
  • NY Medicaid 02349659
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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