Provider Demographics
NPI:1508123332
Name:NICHOLS, BARBARA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LOUISE
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11 MILLICENT DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-1826
Mailing Address - Country:US
Mailing Address - Phone:631-488-4030
Mailing Address - Fax:631-488-4031
Practice Address - Street 1:11 MILLICENT DRIVE
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-1826
Practice Address - Country:US
Practice Address - Phone:631-488-4030
Practice Address - Fax:631-488-4031
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY143069208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery