Individual
DR. ROBERT JOSEPH NICOLETTA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
725 ALBANY ST, SHAPIRO 4, SUITE B, BOSTON, MA 02118-2526
(617) 638-5633
(617) 414-5226
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
212596
MA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
212596
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110073470A
—
MA
Enumeration date
01/19/2006
Last updated
05/21/2014
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