Healthcare Provider Details

I. General information

NPI: 1790629467
Provider Name (Legal Business Name): NINA PADRO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 TAUNTON ST
PLAINVILLE MA
02762-2131
US

IV. Provider business mailing address

360 US HIGHWAY 1 BYP UNIT 102
PORTSMOUTH NH
03801-7105
US

V. Phone/Fax

Practice location:
  • Phone: 508-928-5211
  • Fax: 508-928-5212
Mailing address:
  • Phone: 603-410-6700
  • Fax: 603-309-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA102653
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: