Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole Innace

Individual provider Specialist · NPI 1578974630

Nicole Innace is a Specialist in Holbrook, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2014
Specialties on file
3

Practice location Address checks out

45 Timber Ridge Dr
Holbrook, NY 11741-4142
Phone: (631) 472-8162
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 353185091 (NY)
Specialist Taxonomy 174400000X · Licence 415945101 (NY)
Specialist Taxonomy 174400000X · Licence 800217131 (NY)

Record details

NPI number1578974630
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 12, 2014
Last updated in NPPESApril 10, 2015

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