Provider Demographics
NPI:1205248127
Name:CIOTOLA, NICHOLAS
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:CIOTOLA
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 1:386 MERRIMACK ST #1B
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844
Mailing Address - Country:US
Mailing Address - Phone:978-682-0382
Mailing Address - Fax:
Practice Address - Street 1:386 MERRIMACK ST # 1B
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5802
Practice Address - Country:US
Practice Address - Phone:978-682-0382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006784213ES0103X
MA2462213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery