JACQUELINE CHANTAL NICOLICH

SOUTHAMPTON, NY
NPI1346780046
Former NameJACQUELINE CHANTAL ROSANTE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: NY  020637)
Enumeration Date2017-02-28
Last Update Date2025-04-21
Business Address
JACQUELINE CHANTAL NICOLICH RPA-C
MEETING HOUSE LANE MEDICAL PRACTICE, PC SURGICAL SPEC. 240
SOUTHAMPTON, NY 11968
Phone number: 631-726-8717
Mailing Address
JACQUELINE CHANTAL NICOLICH RPA-C
4 SPRINGVILLE RD STE B
HAMPTON BAYS, NY 11946-2290
Phone number: 631-726-8717
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