Individual
NICOLE D COLUCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
319 S MANNING BLVD STE 201, ALBANY, NY 12208-1743
(518) 516-6724
(518) 708-8773
Mailing address
319 S MANNING BLVD STE 201, ALBANY, NY 12208-1743
(518) 516-6724
(518) 708-8773
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
232155
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10087875
CDPHP PROVIDER #
NY
01
—
782072
MVP PROVIDER #
NY
01
—
P00294582
RAILROAD MEDICARE
NY
Enumeration date
04/14/2006
Last updated
01/26/2025
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