Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 343512 | NY |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 343512 | NY |
NPI | 1124502810 |
---|---|
Provider Name | Nicholas Pikarsky |
First Address | Syracuse, NY 13214-1845 |
Second Address | Syracuse, NY 13214-1845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2018 |
Last Update Date | 10/12/2020 |