Provider Demographics
NPI:1891033155
Name:CUTLER, NICOLE (LAC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:CUTLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CHERRY HILL RD.
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561
Mailing Address - Country:US
Mailing Address - Phone:845-901-0271
Mailing Address - Fax:
Practice Address - Street 1:400 ROUTE 211 E
Practice Address - Street 2:SUITE 12
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2122
Practice Address - Country:US
Practice Address - Phone:845-381-1164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2901-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist