| Doctor Name: | DR. NICHOLAS BRUCE FORMICA |
| NPI Number: | 1013927722 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 027799 |
| Business Practice Address: | 240 East St Plainville, CT - 060622935 |
| Business Phone Number: | 8607931151 |
| Business Fax Number: | 8607931519 |
| Mailing Address: | 240 East St, PLAINVILLE |
| State: | CT |
| Postal Code: | 060622935 |
| Phone Number: | 8607931151 |
| Fax Number: | 8607931519 |
| NPI Enumeration Date: | 08/08/2006 |
| NPI Last Update Date: | 07/19/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RR0500X |
| License Number: | 027799 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Rheumatology |
| Taxonomy Definition: | An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |