Provider Demographics
NPI:1417063025
Name:ARENA, NANCY F (PA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:F
Last Name:ARENA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 LIBBEY PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-3157
Mailing Address - Country:US
Mailing Address - Phone:617-421-1091
Mailing Address - Fax:781-682-0611
Practice Address - Street 1:90 LIBBEY PKWY STE 201
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3157
Practice Address - Country:US
Practice Address - Phone:617-421-1091
Practice Address - Fax:781-682-0611
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT000647207RG0100X
MAPA2268363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
S65314Medicare UPIN