Provider Demographics
NPI:1609655604
Name:GORMAN-ZOLOCHIK, NICHOLAS JOSEPH (BSN,RN)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:JOSEPH
Last Name:GORMAN-ZOLOCHIK
Suffix:
Gender:M
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 TORKER STREET
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709
Mailing Address - Country:US
Mailing Address - Phone:215-350-7269
Mailing Address - Fax:
Practice Address - Street 1:735 MAPLETON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709
Practice Address - Country:US
Practice Address - Phone:302-224-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0054266390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program