Individual provider · Type 1 NPI
Jacqueline Chantal Nicolich, RPA-C
Surgical Physician Assistant · Southampton, NY
NPI number
1346780046
Active
Practice location
Meeting House Lane Medical Practice, Pc Surgical Spec., 240
Southampton, NY 11968
Fax (631) 726-8720
Mailing address
4 Springville Rd Ste B
Hampton Bays, NY 11946-2290
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 020637 (NY) |
Surgical Physician Assistant: Definition to come...
Other surgical physician assistant providers in Southampton
About NPI 1346780046
Jacqueline Chantal Nicolich, RPA-C's National Provider Identifier is 1346780046, issued on Feb 28, 2017. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Southampton, NY. The record was last updated on Apr 21, 2025.