Most Relevant Information
Provider Data
| NPI Number: | 1003495052 |
| Provider Name: | NICHOLAS JOHN BELLACICCO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/06/2021 |
| Last Updated: | 04/06/2021 |
Provider Practice Location
90 BERGEN ST STE 5200
NEWARK
NJ
071032425
Practice Location Phone/Fax
| Phone: | 9739725209 |
| Fax: |
Provider Mailing Location
90 BERGEN ST STE 5200
NEWARK
NJ
071032425
Provider Mailing Phone/Fax
| Phone: | 9739725209 |
| Fax: |