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
Mailing address32 Kenwood Dr, Bohemia, NY 11716-1314

Other providers in Holbrook