Nicole Tamara Nicholas, M.A.

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

14000046735 Issued in NY

Practice address

22703 113TH Ave
Queens Village, NY 11429-2712

Phone

(718) 810-3931

NPI assigned

Mar 15, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426377600000",
    "number": "1790178796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22703 113TH AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292712",
            "telephone_number": "718-810-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22703 113TH AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292712",
            "telephone_number": "718-810-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "NICOLE",
        "middle_name": "TAMARA",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-15",
        "last_updated": "2015-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002208",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NY",
            "license": "14000046735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist-Hearing Aid Fitter in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Audiologist-Hearing Aid Fitter in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.