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General NPI Number Information
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NPI Number | 1932174380
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Entity Type | Individual
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Provider Name | NINA LIVINGSTON MD
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 282 WASHINGTON ST
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City | HARTFORD
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State | CT
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Zip | 06106-3322
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Country | US
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Telephone | 860-610-5890
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Fax | 860-545-8085
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone | 505-272-1476
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Fax | 860-545-8085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD2024-0975
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 038540
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License Number State | CT
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