Provider Demographics
NPI:1922074194
Name:BERLEY, NANCY K (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:K
Last Name:BERLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:102 SHORE DR
Mailing Address - Street 2:SUITE 403
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3154
Mailing Address - Country:US
Mailing Address - Phone:508-852-5230
Mailing Address - Fax:508-842-1402
Practice Address - Street 1:102 SHORE DR
Practice Address - Street 2:SUITE 403
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3154
Practice Address - Country:US
Practice Address - Phone:508-852-5230
Practice Address - Fax:508-842-1402
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA226285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2110334Medicaid
MA2110334Medicaid
MABE A38992Medicare ID - Type Unspecified