Provider Demographics
NPI:1619231354
Name:HOVER, NICOLE A (RPA-C)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:HOVER
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:AMC COMMUNITY GI
Mailing Address - Street 2:1769 UNION STREET
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309
Mailing Address - Country:US
Mailing Address - Phone:518-264-4895
Mailing Address - Fax:518-881-0003
Practice Address - Street 1:1220 NEW SCOTLAND RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-9386
Practice Address - Country:US
Practice Address - Phone:518-439-4326
Practice Address - Fax:518-439-6143
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY015671363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant