Provider Demographics
NPI:1942565528
Name:DIGNAZIO, NICHOLAS D (PA-C)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:D
Last Name:DIGNAZIO
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:352 S DELSEA DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5308
Mailing Address - Country:US
Mailing Address - Phone:856-690-1616
Mailing Address - Fax:856-690-1089
Practice Address - Street 1:352 S DELSEA DR UNIT C
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5308
Practice Address - Country:US
Practice Address - Phone:856-690-1616
Practice Address - Fax:856-690-1089
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2024-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA055388363A00000X
NJ25MP00283900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant