Healthcare Provider Details

I. General information

NPI: 1144649575
Provider Name (Legal Business Name): NANCY I JOSEPH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 STATE ST FL 26
BOSTON MA
02109-1827
US

IV. Provider business mailing address

75 STATE ST FL 26
BOSTON MA
02109-1827
US

V. Phone/Fax

Practice location:
  • Phone: 617-204-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number34.013012
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number036.174806
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number281421
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number297572
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number281421
License Number StateMA
# 6
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number76966
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: