Provider Demographics
NPI:1396359329
Name:NICHOLAS, TROY N (LMT)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:N
Last Name:NICHOLAS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CHASE RD UNIT 445
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7662
Mailing Address - Country:US
Mailing Address - Phone:347-773-2600
Mailing Address - Fax:
Practice Address - Street 1:29 CHASE RD UNIT 445
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-7662
Practice Address - Country:US
Practice Address - Phone:347-773-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012233225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist