Provider Demographics
NPI:1841453305
Name:NICOLO, DANIELLE MICHELLE (MD, PHD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MICHELLE
Last Name:NICOLO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:425 E 61ST ST
Mailing Address - Street 2:12TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8722
Mailing Address - Country:US
Mailing Address - Phone:215-850-0911
Mailing Address - Fax:646-962-0139
Practice Address - Street 1:425 E 61ST ST
Practice Address - Street 2:12 FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8722
Practice Address - Country:US
Practice Address - Phone:646-962-2399
Practice Address - Fax:646-962-0139
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-05
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY259798207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease