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General NPI Number Information
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NPI Number | 1962310482
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Entity Type | Individual
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Provider Name | NICOLE MARIE PROCOPIO PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 1114 GOFFLE RD STE 104
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City | HAWTHORNE
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State | NJ
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Zip | 07506-2014
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Country | US
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Telephone | 973-636-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1114 CLINTON AVE
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City | SOUTH PLAINFIELD
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State | NJ
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Zip | 07080-1610
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Country | US
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Telephone | 908-451-6007
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NJ
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