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General NPI Number Information
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NPI Number | 1972543791
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Entity Type | Organization
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Legal Business Name | THOMAS R NUCATOLA MD LLC
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 316 E BROAD ST
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City | WESTFIELD
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State | NJ
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Zip | 07090-2122
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Country | US
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Telephone | 908-301-9800
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Fax | 908-301-9801
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Provider Business Mailing Address
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Address Line | 316 E BROAD ST
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City | WESTFIELD
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State | NJ
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Zip | 07090-2122
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Country | US
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Telephone | 908-301-9800
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Fax | 908-301-9801
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. THOMAS R NUCATOLA JR.
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Credential | M.D.
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Telephone | 908-301-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 25MA05172000
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License Number State | NJ
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