Provider Demographics
NPI:1629864673
Name:CONTRERAS, NICOLE Y (MT)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:Y
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:YADIRA
Other - Last Name:CONTRERAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT NICOLE CONTRERAS
Mailing Address - Street 1:1 LINN DR UNIT 1201
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-3123
Mailing Address - Country:US
Mailing Address - Phone:862-944-8030
Mailing Address - Fax:
Practice Address - Street 1:1 LINN DR UNIT 1201
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-3123
Practice Address - Country:US
Practice Address - Phone:862-944-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT01519000163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)Group - Single Specialty