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General NPI Number Information
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NPI Number | 1366403057
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Entity Type | Individual
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Provider Name | JOSEPH ANTHONY NICHOLAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 1000 SOUTH AVE BOX 58
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City | ROCHESTER
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State | NY
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Zip | 14620-2733
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Country | US
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Telephone | 585-341-6770
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Fax | 585-341-8305
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Provider Business Mailing Address
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Address Line | 1000 SOUTH AVE BOX 58
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City | ROCHESTER
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State | NY
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Zip | 14620-2733
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Country | US
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Telephone | 585-341-6770
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Fax | 585-341-8305
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 219959
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 219959
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 219959
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 219959
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License Number State | NY
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