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Contact Information

LEROY J NICKIE
7018 WADE AVE
CLINTON, MD20735-2741
 Phone: 301-877-7085
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Exercise Physiologist

224Y00000X
Indicates primary specialty

NPI Profile & details for LEROY J NICKIE · (Male)

NPI # 1598043507
Status Active
Credentials
Entity Individual
Enumeration date 07/25/2011
Last updated 10/06/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers Not Available
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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