Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicholas Maccollum

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1477434504

Nicholas Maccollum is a Physical Medicine & Rehabilitation Physician in Syracuse, New York. Licensed in New York. Registered with an NPI since 2025.

Licensed in
NY
In the registry since
2025
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Practice location Address checks out

750 E Adams St
Syracuse, NY 13210-2306
Phone: (315) 464-5540
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Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 054559-01 (NY)

Record details

NPI number1477434504
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 8, 2025
Last updated in NPPESSeptember 8, 2025
Certification dateSeptember 8, 2025
Mailing address602 Cherry Rd, Syracuse, NY 13219-2342

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