Active NPI
Tyresha Nicholson
- Student in an Organized Health Care Education/Training Program
- Syracuse, NY
National Provider Identifier
1720996747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 742 James St
Syracuse, NY 13203-2017 - Phone
- (315) 703-2712
- NPI assigned
- Aug 31, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
742 James St
Syracuse, NY 13203-2017
Mailing address
350 Electronics Pkwy
Liverpool, NY 13088-6040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1720996747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 ELECTRONICS PKWY",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130886040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "742 JAMES ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132032017",
"telephone_number": "315-703-2712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "TYRESHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-31",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.