Provider Demographics
NPI:1437313293
Name:NICOLA, ALICE HELENA
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:HELENA
Last Name:NICOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 E 64TH ST
Mailing Address - Street 2:APT 2-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7826
Mailing Address - Country:US
Mailing Address - Phone:212-759-6869
Mailing Address - Fax:
Practice Address - Street 1:151 E 67TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5964
Practice Address - Country:US
Practice Address - Phone:212-988-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047960-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical