Provider Demographics
NPI:1578441721
Name:NICOLAI, NATALY ANDREA (PHARMDC)
Entity type:Individual
Prefix:
First Name:NATALY
Middle Name:ANDREA
Last Name:NICOLAI
Suffix:
Gender:F
Credentials:PHARMDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 CALLE CARBONELL UNIT 1106
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-3584
Mailing Address - Country:US
Mailing Address - Phone:787-226-1467
Mailing Address - Fax:
Practice Address - Street 1:64 CALLE CARBONELL UNIT 1106
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-3584
Practice Address - Country:US
Practice Address - Phone:787-226-1467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3235390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program