Provider Demographics
NPI:1205097839
Name:FINE, NANCY E (MED, MSS)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:FINE
Suffix:
Gender:F
Credentials:MED, MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TERRY DR
Mailing Address - Street 2:THE ATRIUM, SUITE 7
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1838
Mailing Address - Country:US
Mailing Address - Phone:215-860-1144
Mailing Address - Fax:215-860-9333
Practice Address - Street 1:4 TERRY DR
Practice Address - Street 2:THE ATRIUM, SUITE 7
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1838
Practice Address - Country:US
Practice Address - Phone:215-860-1144
Practice Address - Fax:215-860-9333
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW004602L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical