Individual ProviderGeorge John NickelSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address97 Dawson Circle, Staten Island, NY 10314-3824(917) 742-4011PECOS EnrollmentBased on the most recent information from CMS, provider George John Nickel does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1013146265Provider TypeIndividualFull NameNickel, George JohnTitleMr.CredentialSLPGenderMaleSole ProprietorYesEnumeration Date7/9/2009Last Updated7/9/2009Contact InformationPractice LocationPractice Address97 Dawson Circle, Staten Island, NY 10314-3824Phone(917) 742-4011FaxUnlisted FaxMailing LocationMailing Address97 Dawson Circle, Staten Island, NY 10314-3824Phone(917) 742-4011FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense009286New York