Provider Demographics
NPI:1356549661
Name:DORIO, NICOLE MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MARIE
Last Name:DORIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 861
Mailing Address - Street 2:NEW JERSEY STATE PRISON
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08625-0861
Mailing Address - Country:US
Mailing Address - Phone:609-292-9700
Mailing Address - Fax:
Practice Address - Street 1:THIRD AND FEDERAL STREETS
Practice Address - Street 2:NEW JERSEY STATE PRISON
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08625-0861
Practice Address - Country:US
Practice Address - Phone:609-292-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-08
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB086961002084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry