Healthcare Provider Details

I. General information

NPI: 1497441307
Provider Name (Legal Business Name): NICHOLAS TOCCI PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 NEW GARDEN RD
GREENSBORO NC
27410-2721
US

IV. Provider business mailing address

113 GLENMORE RD
CHAPEL HILL NC
27516-1149
US

V. Phone/Fax

Practice location:
  • Phone: 336-294-6190
  • Fax: 336-294-6278
Mailing address:
  • Phone: 919-428-0839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: