Healthcare Provider Details

I. General information

NPI: 1336609601
Provider Name (Legal Business Name): NATHALIE NADER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 ROSEMARY ST
NEEDHAM MA
02494-3202
US

IV. Provider business mailing address

40 WILLIAM ST UNIT 432
WELLESLEY MA
02481-3924
US

V. Phone/Fax

Practice location:
  • Phone: 781-444-7186
  • Fax: 781-449-4617
Mailing address:
  • Phone: 978-902-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number291455
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: