Healthcare Provider Details

I. General information

NPI: 1437969029
Provider Name (Legal Business Name): MS. NADINE GABRIELA GELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 CALIFORNIA ST
NEWTON MA
02458-1164
US

IV. Provider business mailing address

149 CALIFORNIA ST
NEWTON MA
02458-1164
US

V. Phone/Fax

Practice location:
  • Phone: 617-699-1929
  • Fax:
Mailing address:
  • Phone: 617-699-1929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2326139
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: