Healthcare Provider Details

I. General information

NPI: 1932187812
Provider Name (Legal Business Name): SIDNEY NIRENBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 ROUTE 130
SANDWICH MA
02563-2340
US

IV. Provider business mailing address

441 ROUTE 130
SANDWICH MA
02563-2340
US

V. Phone/Fax

Practice location:
  • Phone: 508-833-3999
  • Fax: 508-833-3917
Mailing address:
  • Phone: 508-833-3999
  • Fax: 508-833-3917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34555
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: