Provider Demographics
NPI:1609047695
Name:NONNIE M. ESTELLA, MD P.C.
Entity Type:Organization
Organization Name:NONNIE M. ESTELLA, MD P.C.
Other - Org Name:NONNIE M. ESTELLA, MD P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NONNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ESTELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-459-8300
Mailing Address - Street 1:295 VARNUM AVE
Mailing Address - Street 2:3RD FLOOR HANCHETT BUILDING
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2134
Mailing Address - Country:US
Mailing Address - Phone:978-459-8300
Mailing Address - Fax:978-459-8302
Practice Address - Street 1:295 VARNUM AVE
Practice Address - Street 2:3RD FLOOR HANCHETT BUILDING
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2134
Practice Address - Country:US
Practice Address - Phone:978-459-8300
Practice Address - Fax:978-459-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160769207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA29947Medicare PIN
MAG54086Medicare UPIN