| Doctor Name: | MRS. KATHLEEN NICPON |
| NPI Number: | 1467664797 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | F332957 |
| Business Practice Address: | 51 N Route 9w West Haverstraw, NY - 109931127 |
| Business Phone Number: | 8457864109 |
| Business Fax Number: | 8457864526 |
| Mailing Address: | 50-51 Rt 9w, WEST HAVERSTRAW |
| State: | NY |
| Postal Code: | 109931195 |
| Phone Number: | 8457864109 |
| Fax Number: | 8457864526 |
| NPI Enumeration Date: | 05/07/2007 |
| NPI Last Update Date: | 01/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F332957 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |