Individual
NICKOLAS L. PEZZELLA
Active
Individual
NICKOLAS L. PEZZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101057162
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006800688
—
VA
01
—
250011832
MEDICARE RR
VA
01
—
P00799764
RR MEDICARE
VA
Enumeration date
07/20/2006
Last updated
04/08/2010
Update your record
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