Provider Demographics
NPI:1992105977
Name:CONNORS, NICOLE ANNA
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ANNA
Last Name:CONNORS
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 1:2370 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-2106
Mailing Address - Country:US
Mailing Address - Phone:516-547-5933
Mailing Address - Fax:
Practice Address - Street 1:2370 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-2106
Practice Address - Country:US
Practice Address - Phone:516-547-5933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist