MEDICARE: DR. NANCY CAROL NITENSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0802X	Addiction Psychiatry Physician	59161	MA

General Provider Information

NPI Number	:	1497804702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY CAROL NITENSON MD

Provider Business Mailing Address
First Line	:	935 GREAT PLAIN AVE # 117
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-3031
Country	:	US
Telephone Number	:	617-608-3724
Fax Number	:

Provider Business Practice Location Address
First Line	:	935 GREAT PLAIN AVE # 117
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-3031
Country	:	US
Telephone Number	:	617-608-3724
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	01/26/2024

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