Provider Demographics
NPI:1447243290
Name:VOTOLATO, NICHOLAS ANTHONY (RPH BCPP)
Entity Type:Individual
Prefix:PROF
First Name:NICHOLAS
Middle Name:ANTHONY
Last Name:VOTOLATO
Suffix:
Gender:M
Credentials:RPH BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 ARYSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-8675
Mailing Address - Country:US
Mailing Address - Phone:614-766-9626
Mailing Address - Fax:614-293-4886
Practice Address - Street 1:1670 UPHAM DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1250
Practice Address - Country:US
Practice Address - Phone:614-293-4876
Practice Address - Fax:614-293-4886
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031109741835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric