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General NPI Number Information
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NPI Number | 1912920034
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Entity Type | Individual
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Provider Name | DONALD E MCNICOL JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 34 MAPLE ST
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City | NORWALK
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State | CT
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Zip | 06850-3815
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Country | US
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Telephone | 203-852-3494
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Fax |
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Provider Business Mailing Address
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Address Line | 34 MAPLE ST
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City | NORWALK
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State | CT
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Zip | 06850-3815
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Country | US
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Telephone |
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 165760
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 165760
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 45196
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License Number State | CT
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