Provider Demographics
NPI:1235384561
Name:QUERCETTI, NICHOLAS F III (DO)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:F
Last Name:QUERCETTI
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 LIMESTONE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5413
Mailing Address - Country:US
Mailing Address - Phone:302-633-3555
Mailing Address - Fax:302-633-3559
Practice Address - Street 1:1941 LIMESTONE RD
Practice Address - Street 2:STE 101
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5413
Practice Address - Country:US
Practice Address - Phone:302-633-3555
Practice Address - Fax:302-633-3559
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0010961207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEP01348209OtherRAILROAD
DE1235384561Medicaid
DE1235384561Medicaid