Organization
THOMAS NICOLLA PT OF DELMAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS NICOLLA (OWNER)
(518) 786-1667
Entity
Organization
Contact information
Practice address
10 VISTA BLVD, SLINGERLANDS, NY 12159-2187
(518) 478-9049
(518) 478-0133
Mailing address
711 TROY SCHENECTADY RD, SUITE 209, LATHAM, NY 12110-2442
(518) 786-1667
(518) 786-1954
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000413955001
BSNENY
NY
01
—
CH8550
RAILROAD MEDICARE
NY
Enumeration date
05/31/2007
Last updated
05/10/2017
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