Provider Demographics
NPI:1790775104
Name:HARRINGTON, NICOLE C (PT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:C
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:C
Other - Last Name:PINHEIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1574 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-6120
Mailing Address - Country:US
Mailing Address - Phone:518-374-2127
Mailing Address - Fax:518-374-2142
Practice Address - Street 1:1574 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-6120
Practice Address - Country:US
Practice Address - Phone:518-374-2127
Practice Address - Fax:518-374-2142
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0221671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0184495Medicaid
NY0184495Medicaid
PD0893Medicare ID - Type Unspecified