Provider Demographics
NPI:1427885490
Name:D'AMICO, NICHOLAS ANGELO
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:ANGELO
Last Name:D'AMICO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-2240
Mailing Address - Country:US
Mailing Address - Phone:610-563-7723
Mailing Address - Fax:
Practice Address - Street 1:150 CRESTVIEW DR
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-2240
Practice Address - Country:US
Practice Address - Phone:610-563-7723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer