Provider Demographics
NPI:1619288073
Name:ROY, NICHOLAS (DO)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:ROY
Suffix:
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 1:107 BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3526
Mailing Address - Country:US
Mailing Address - Phone:856-429-1800
Mailing Address - Fax:856-429-1081
Practice Address - Street 1:107 BERLIN ROAD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034
Practice Address - Country:US
Practice Address - Phone:856-429-1800
Practice Address - Fax:856-429-1081
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09385100207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease