Jacqueline Chantal Nicolich, RPA-C
Jacqueline Chantal Nicolich, RPA-C is a Physician Assistant in Southampton, New York. Qualified in 2016, 10 years ago. Practices with Meeting House Lane Medical Practice PC, a 123-clinician group and accepts Medicare assignment. Licensed in New York.
- Years since qualifying
- 10
- Licensed in
- NY
- In the registry since
- 2017
Practice location Partly verified
Meeting House Lane Medical Practice Pc Surgical Spec 240Southampton, NY 11968
Phone: (631) 726-8717
Fax: (631) 726-8720
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Surgical Physician Assistant (primary) | Taxonomy 363AS0400X · Licence 020637 (NY) |
|---|
Record details
| NPI number | 1346780046 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | RPA-C |
| Sole proprietor | No |
| NPI enumerated | February 28, 2017 |
| Last updated in NPPES | April 21, 2025 |
| Certification date | April 21, 2025 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2016 (10 years in practice) |
| Group practice | Meeting House Lane Medical Practice Pc — 123 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 3 on file with Medicare |
Other providers in Southampton
-
Kristie McLaren, R-PA
365 County Road 39A Ste 11, Southampton, NY 11968-5284 · (631) 591-3992
-
Peter D Shelton, PA
325 Meeting House Ln Bldg 2 Ste 301, Southampton, NY 11968-5087 · (631) 287-9477