Individual
J NICHOLAS PORCELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051311
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00001783898
UNITED CONCORDIA
NY
01
—
00025887504
UNIVERA/HEALTHPLEX
NY
01
—
000527781001
BC/BS OF WNY
NY
Enumeration date
05/04/2006
Last updated
12/30/2016
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