Provider Demographics
NPI:1972543791
Name:THOMAS R NUCATOLA MD LLC
Entity Type:Organization
Organization Name:THOMAS R NUCATOLA MD LLC
Other - Org Name:ARTHRITIS CENTER OF WESTFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:NUCATOLA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:908-301-9800
Mailing Address - Street 1:316 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2122
Mailing Address - Country:US
Mailing Address - Phone:908-301-9800
Mailing Address - Fax:908-301-9801
Practice Address - Street 1:316 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2122
Practice Address - Country:US
Practice Address - Phone:908-301-9800
Practice Address - Fax:908-301-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05172000207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherFEDERAL TAX IDENTIFICATIO