Provider Demographics
NPI:1851739460
Name:NICHOLS, JULIANNE HEIDI (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIANNE
Middle Name:HEIDI
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14240-0488
Mailing Address - Country:US
Mailing Address - Phone:866-853-9551
Mailing Address - Fax:203-916-1041
Practice Address - Street 1:5959 BIG TREE RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2291
Practice Address - Country:US
Practice Address - Phone:716-710-8266
Practice Address - Fax:716-710-8267
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2020-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY299821207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease