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Contact Information

NICHOLAS BACCIOCCO
1850 BITTERROOT DR
TWIN FALLS, ID83301-3513
 Phone: 801-674-5752
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for NICHOLAS BACCIOCCO · (Male)

NPI Number 1104235720
Status Active
Credentials
Entity Individual
Enumeration date 08/07/2014
Last updated 08/07/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • ID License # OTA-1351
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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