Provider Demographics
NPI:1356085633
Name:BIROTTE, NANCY (RT(R) (CT))
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BIROTTE
Suffix:
Gender:F
Credentials:RT(R) (CT)
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:BIROTTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RT (R) (CT)
Mailing Address - Street 1:10525 TRUXTON RD
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1123
Mailing Address - Country:US
Mailing Address - Phone:240-663-1045
Mailing Address - Fax:
Practice Address - Street 1:10525 TRUXTON RD
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1123
Practice Address - Country:US
Practice Address - Phone:240-663-1045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-23
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR00097982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology