Provider Demographics
NPI:1871909853
Name:LAMASTER, NICHOLE (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:
Last Name:LAMASTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 SUNDRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1803
Mailing Address - Country:US
Mailing Address - Phone:240-447-7047
Mailing Address - Fax:
Practice Address - Street 1:1708 JEFFERSON AVE STE 240
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-4309
Practice Address - Country:US
Practice Address - Phone:618-731-1965
Practice Address - Fax:618-316-7206
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012657111N00000X
IN08002774A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1871909853Medicare PIN