Provider Demographics
NPI:1700938065
Name:PACE, NICHOLAS ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ANTHONY
Last Name:PACE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:244 E 58TH ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2001
Mailing Address - Country:US
Mailing Address - Phone:917-270-5342
Mailing Address - Fax:212-371-3816
Practice Address - Street 1:767 5TH AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10153-0023
Practice Address - Country:US
Practice Address - Phone:212-418-6450
Practice Address - Fax:212-418-6115
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2016-02-19
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Provider Licenses
StateLicense IDTaxonomies
NY086240207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY175941Medicare ID - Type Unspecified
NYB10466Medicare UPIN