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

Mr. Nicklos Blaylock

Individual provider Registered Nurse · NPI 1255632675

Mr. Nicklos Blaylock is a Registered Nurse in Bay Shore, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2010

Practice location Address checks out

19 20th Ave
Bay Shore, NY 11706-3109
Phone: (631) 328-4292
Fax: (631) 647-4613
Show map & directions

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

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 590968-1 (NY)

Record details

NPI number1255632675
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 17, 2010
Last updated in NPPESNovember 17, 2010
Mailing address19 20th Ave, Bay Shore, NY 11706-3109

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