Provider Demographics
NPI:1255364006
Name:NICETA, PIERO (MD)
Entity type:Individual
Prefix:DR
First Name:PIERO
Middle Name:
Last Name:NICETA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801
Mailing Address - Country:US
Mailing Address - Phone:914-636-2121
Mailing Address - Fax:914-636-3625
Practice Address - Street 1:120 WARREN ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-636-2121
Practice Address - Fax:914-636-3625
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108238208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00191213Medicaid
NY00191213Medicaid
NY677481Medicare PIN