Provider Demographics
NPI:1497051932
Name:NUCCIO, GERALD (DC)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:
Last Name:NUCCIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 TURIN ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-3315
Mailing Address - Country:US
Mailing Address - Phone:315-292-0200
Mailing Address - Fax:315-336-2219
Practice Address - Street 1:406 TURIN ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-3315
Practice Address - Country:US
Practice Address - Phone:315-292-0200
Practice Address - Fax:315-336-2219
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012375-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor