Provider Demographics
NPI:1922147669
Name:NICOLAI, CHARLES V (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:V
Last Name:NICOLAI
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 1:75 WALL ST
Mailing Address - Street 2:SUITE 19G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-2833
Mailing Address - Country:US
Mailing Address - Phone:212-747-0347
Mailing Address - Fax:
Practice Address - Street 1:75 WALL ST
Practice Address - Street 2:SUITE 19G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-2833
Practice Address - Country:US
Practice Address - Phone:212-747-0347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001708111N00000X
NYXO11849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor