Healthcare Provider Details

I. General information

NPI: 1609855576
Provider Name (Legal Business Name): NANCY BERLINER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROOKLINE AVE YAWKEY CENTER
BOSTON MA
02215-5418
US

IV. Provider business mailing address

75 FRANCIS ST
BOSTON MA
02115-6110
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-6089
  • Fax: 617-264-5215
Mailing address:
  • Phone: 617-732-5840
  • Fax: 617-264-5215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number53113
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: