Pezzella, Nickolas L.

Pezzella, Nickolas L. is an individual health care provider with primary practice located at 2012 Meade Pkwy , Suffolk VA 23434-4259. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Pezzella, Nickolas L. can be contacted via phone (757) 538-0102.

Contact Information

Primary practice address
2012 Meade Pkwy Suffolk VA 23434-4259
Phone: (757) 538-0102
Fax: (757) 538-1833
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 0101057162 Virginia

Profile Details

NPI number 1932129475
LBN Legal business name Pezzella, Nickolas L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Apr 8th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932129475 NPPES
Virginia Other P00799764 RR MEDICARE
Virginia Other 250011832 RR MEDICARE
Virginia MEDICAID 006800688 RR MEDICARE

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