Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 219959 | NY |
Y | 111NI0900X | Internist | 219959 | NY |
N | 207RH0002X | Hospice and Palliative Medicine | 219959 | NY |
NPI | 1366403057 |
---|---|
Provider Name | Dr. Joseph Anthony Nicholas |
First Address | Rochester, NY 14620-2733 |
Second Address | Rochester, NY 14620-2733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 13/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02669221 | (05) | NY |
H42328 | (02) | NY |
MDJ201 | PREFERRED CARE (01) | NY |