Provider Demographics
NPI:1952790719
Name:ORLOWSKY, NICHOLAS J (PA-C)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:ORLOWSKY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LIBERTY PLZ STE 301
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-1404
Mailing Address - Country:US
Mailing Address - Phone:917-261-4414
Mailing Address - Fax:
Practice Address - Street 1:765 HAYWOOD RD STE I
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2772
Practice Address - Country:US
Practice Address - Phone:864-520-2020
Practice Address - Fax:864-640-4400
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9114835363A00000X
SC3971363A00000X
COPA.0007147363A00000X
CT5297363A00000X
MI5601010542363A00000X
MAPA8644363A00000X
MDC0008251363A00000X
NY026615-01363A00000X
NC0010-10878363A00000X
NJ25MP00639000363A00000X
GA10953363A00000X
IL085.008340363A00000X
DCPA200001239363A00000X
DEC5-0011694363A00000X
CA60541363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant