Healthcare Provider Details

I. General information

NPI: 1184002255
Provider Name (Legal Business Name): MICHAEL NICOARA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOSPITAL AVE
DANBURY CT
06810-6099
US

IV. Provider business mailing address

24 HOSPITAL AVE
DANBURY CT
06810-6099
US

V. Phone/Fax

Practice location:
  • Phone: 203-739-7000
  • Fax:
Mailing address:
  • Phone: 203-739-7131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number17428093
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number69111
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: