Provider Demographics
NPI:1669037263
Name:SPEAR, NICHOLAS (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:SPEAR
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2446 CLIFF LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1727
Mailing Address - Country:US
Mailing Address - Phone:516-301-0593
Mailing Address - Fax:
Practice Address - Street 1:2446 CLIFF LN
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1727
Practice Address - Country:US
Practice Address - Phone:516-301-0593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028178235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist