Provider Demographics
NPI:1295856292
Name:MICHAEL A NOCITO DC
Entity Type:Organization
Organization Name:MICHAEL A NOCITO DC
Other - Org Name:NOCITO FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOCITO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-971-0174
Mailing Address - Street 1:1100 W VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1447
Mailing Address - Country:US
Mailing Address - Phone:610-971-0174
Mailing Address - Fax:
Practice Address - Street 1:1100 W VALLEY RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1447
Practice Address - Country:US
Practice Address - Phone:610-971-0174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006578L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA075137OtherBLUE CARD ID#
PA1446309OtherPERSONAL CHOICE ID#
PA1446309OtherPERSONAL CHOICE ID#