Individual
MICHAEL NICOLAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16 POCONO ROAD, SUITE 317, DENVILLE, NJ 07834
(973) 627-2650
(973) 627-8383
Mailing address
404 LIPPINCOTT DR, MARLTON, NJ 08053-4112
(856) 782-3300
(856) 504-8029
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA06081000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110120472
RAILROAD MEDICARE
NJ
01
—
2T7191
WELLCHOICE
—
05
—
6306004
—
NJ
01
—
IP183
OXFORD
NJ
Enumeration date
06/15/2006
Last updated
12/10/2021
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