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General NPI Number Information
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NPI Number | 1437206562
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Entity Type | Individual
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Provider Name | NICOLE P PISCATELLI M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 55 LAKE AVE N
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City | WORCESTER
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State | MA
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Zip | 01655-0002
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Country | US
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Telephone | 508-859-5288
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Fax | 508-856-4224
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Provider Business Mailing Address
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Address Line | 3141 N 48TH ST
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City | PHOENIX
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State | AZ
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Zip | 85018-6564
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Country | US
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Telephone | 802-310-9302
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Fax |
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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 | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 249491
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 4301106577
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 82-320
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | MD453740
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 47176
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License Number State | AZ
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Taxonomy #6
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 249491
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License Number State | MA
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