Basic Information
Provider Information
NPI: 1326591413
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VINCKIER
FirstName: NICOLE
MiddleName: SAPIRO
NamePrefix: MRS.
NameSuffix:  
Credential: P.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 35046 WOODWARD AVE
Address2: STE 100
City: BIRMINGHAM
State: MI
PostalCode: 480090932
CountryCode: US
TelephoneNumber: 2486479860
FaxNumber: 2486479864
Practice Location
Address1: 35046 WOODWARD AVE
Address2: STE 100
City: BIRMINGHAM
State: MI
PostalCode: 480090932
CountryCode: US
TelephoneNumber: 2486479860
FaxNumber: 2486479864
Other Information
ProviderEnumerationDate: 07/26/2016
LastUpdateDate: 07/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X5601007743MIY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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