Provider Demographics
NPI:1962770263
Name:STRATCHAN, NICOLE ERICA
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ERICA
Last Name:STRATCHAN
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 1:11570 237TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3925
Mailing Address - Country:US
Mailing Address - Phone:516-285-1416
Mailing Address - Fax:
Practice Address - Street 1:11570 237TH ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3925
Practice Address - Country:US
Practice Address - Phone:516-285-1416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021487-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist