Provider Demographics
NPI:1821342544
Name:DIAL, NORA CAROLYN (CNM,NP)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:CAROLYN
Last Name:DIAL
Suffix:
Gender:F
Credentials:CNM,NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01070-9753
Mailing Address - Country:US
Mailing Address - Phone:516-659-5601
Mailing Address - Fax:
Practice Address - Street 1:263 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:MA
Practice Address - Zip Code:01070-9753
Practice Address - Country:US
Practice Address - Phone:516-659-5601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY360408363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology