Individual
JEFFREY JOSEPH NICCOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2225 CENTRAL AVE, ALAMEDA, CA 94501
(510) 521-3410
(510) 521-2521
Mailing address
2225 CENTRAL AVE, ALAMEDA, CA 94501
(510) 521-3410
(510) 521-2521
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3781
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E37810
MEDICARE
CA
Enumeration date
04/01/2006
Last updated
02/11/2015
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