Provider Demographics
NPI:1376877506
Name:TOLCHIN, NICHOLAS
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:TOLCHIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-6918
Mailing Address - Country:US
Mailing Address - Phone:973-224-5028
Mailing Address - Fax:
Practice Address - Street 1:45 W 21ST ST
Practice Address - Street 2:SUITE 6D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6865
Practice Address - Country:US
Practice Address - Phone:973-224-5028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018227103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical