Provider Demographics
NPI:1720563794
Name:TURCO, NICHOLAS (PA)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:TURCO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-225-6552
Practice Address - Street 1:4050 N GEORGE STREET EXT
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:PA
Practice Address - Zip Code:17345-9347
Practice Address - Country:US
Practice Address - Phone:717-356-4370
Practice Address - Fax:717-260-3316
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060367363A00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103604330Medicaid