Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 042.0013219 | VT |
Y | 207P00000X | Emergency Physician | 265045 | NY |
N | 207RA0401X | Internist - Addiction Medicine | 265045 | NY |
NPI | 1255650263 |
---|---|
Provider Name | Dr. Nicholas E Nacca |
First Address | Syracuse, NY 13212-4516 |
Second Address | Syracuse, NY 13210-2306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2010 |
Last Update Date | 06/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03583713 | (05) | NY |