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Individual

DR. NICHOLAS DOMINIC ANNICHIARICO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2050 VERSAILLES RD, STE U102, LEXINGTON, KY 40504
(859) 257-4888
(859) 323-1123
Mailing address
2050 VERSAILLES RD, LEXINGTON, KY 40504
(859) 257-4890

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
05002
KY
208100000X
Physical Medicine & Rehabilitation Physician
R4002
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/24/2016
Last updated
06/25/2021
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