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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. CHARLES D NICOLAIS, M.D.

Active

DR. CHARLES D NICOLAIS, M.D. is a Hospice and Palliative Medicine healthcare provider located in FAYETTEVILLE, New York. NPI 1649533746 is currently active in the NPPES registry. Verify at CMS.

Hospice and Palliative Medicine · FAYETTEVILLE, NY

Registration Details

NPI Number
1649533746
Provider Type
Individual
Gender
Male
NPI Issued
Jun 22, 2012 (14.161685087341 yrs)
Last Updated
Apr 17, 2023
Licenses
MD454351 (PA)
308533-01 (NY)
308533-01 (NY)
308533-01 (NY)

Practice Information

Address
4000 MEDICAL CENTER DRIVE
FAYETTEVILLE, NY, 13202
Browse NY providers · Browse ZIP 13202
Phone
3157441570
Fax
3157441940
Primary Specialty
Hospice and Palliative Medicine
207RI0011X
Additional Specialty
Internal Medicine
Additional Specialty
Cardiovascular Disease
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.