Provider Demographics
NPI:1316799794
Name:BABKOWSKI, NICOLE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BABKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EILEEN DONDERO FOLEY AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4596
Mailing Address - Country:US
Mailing Address - Phone:603-368-6500
Mailing Address - Fax:
Practice Address - Street 1:100 EILEEN DONDERO FOLEY AVE STE 110
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4596
Practice Address - Country:US
Practice Address - Phone:603-368-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2025-05-19
Deactivation Date:2025-03-24
Deactivation Code:
Reactivation Date:2025-05-15
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program