Most Relevant Information
Provider Data
| NPI Number: | 1003027459 |
| Provider Name: | MARTIN HAYNES NICOL PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 003345-1 |
Most Important Dates
| Enumeration Date: | 05/25/2007 |
| Last Updated: | 07/18/2012 |
Provider Practice Location
2367-69 2ND AVE
NEW YORK
NY
100353108
Practice Location Phone/Fax
| Phone: | 2128762300 |
| Fax: | 2123698209 |
Provider Mailing Location
145 REMSEN AVE
BROOKLYN
NY
112121342
Provider Mailing Phone/Fax
| Phone: | 7184674280 |
| Fax: |