Provider Demographics
NPI:1639651144
Name:LITTZI, NICOLAS MICHAEL
Entity Type:Individual
Prefix:MR
First Name:NICOLAS
Middle Name:MICHAEL
Last Name:LITTZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 E GREEN ST
Mailing Address - Street 2:
Mailing Address - City:NANTICOKE
Mailing Address - State:PA
Mailing Address - Zip Code:18634-2411
Mailing Address - Country:US
Mailing Address - Phone:570-817-1869
Mailing Address - Fax:
Practice Address - Street 1:266 E GREEN ST
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-2411
Practice Address - Country:US
Practice Address - Phone:570-817-1869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program