National Provider Identifier

Roxane Nicholson, PT

Roxane Nicholson, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Newark, NY and a listed phone number of (315) 331-7741.

NPI 1942878269Newark, NYPhysical Therapist

Profile Overview

NPI
1942878269
Provider Type
Individual
Primary Specialty
Physical Therapist
Enumeration Date
June 14, 2021
Last Updated
October 21, 2024

Practice Location

  • 150 Vanburen Street
  • Newark, NY 14513

Phone: (315) 331-7741

Mailing Address

  • 508 Vienna St Lot 13
  • Newark, NY 14513-9160

Specialties

  • Physical Therapist (225100000X)
  • Physical Therapy Clinic/Center (261QP2000X)
Full Record
NPI
1942878269
Entity Type
Individual
Last Name
Nicholson
First Name
Roxane
Credential
PT
Mailing Street Address
508 Vienna St Lot 13
Mailing City
Newark
Mailing State
NY
Mailing ZIP Code
14513-9160
Mailing Country
US
Mailing Phone
(585) 966-9166
Practice Street Address
150 Vanburen Street
Practice City
Newark
Practice State
NY
Practice ZIP Code
14513
Practice Country
US
Practice Phone
(315) 331-7741
Enumeration Date
June 14, 2021
Last Updated
October 21, 2024
Sex
Female
Sole Proprietor
Yes
Certification Date
October 16, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapist (225100000X), Physical Therapy Clinic/Center (261QP2000X)