Provider Demographics
NPI:1366273203
Name:NICHOLS, ZOEY (GC)
Entity type:Individual
Prefix:
First Name:ZOEY
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 COTTON ST APT 5
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-1561
Mailing Address - Country:US
Mailing Address - Phone:301-643-7535
Mailing Address - Fax:
Practice Address - Street 1:4701 OGLETOWN RD
Practice Address - Street 2:SUITE 220
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-623-0106
Practice Address - Fax:302-623-4845
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS