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Nicholas Michael Randall

Peer Specialist in Orchard Park, NY. Individual provider (NPI-1).

NPI number1366090540
StatusActive
Last updated in NPPESAug 30, 2019

Details

NPI
1366090540
Entity type
Individual (NPI-1)
Name
Nicholas Michael Randall
Sex
Male
Sole proprietor
No
Enumeration date
Aug 30, 2019
Last updated
Aug 30, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
175T00000X Peer Specialist––Yes

Practice location

3176 Abbott Rd Ste 500
Orchard Park, NY 14127-1069

Phone 716-822-2177 · Fax 716-822-8165

Mailing address

3176 Abbott Rd Ste 500
Orchard Park, NY 14127-1069

Phone 716-822-2177 · Fax 716-822-8165

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Other Peer Specialist providers in Orchard Park, NY

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