Provider Demographics
NPI:1205876588
Name:MADIGAN, NANCY KAY (PHD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:KAY
Last Name:MADIGAN
Suffix:
Gender:F
Credentials:PHD
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Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER - KIRSTEIN 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-4606
Mailing Address - Fax:617-667-7981
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER - KIRSTEIN 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-4606
Practice Address - Fax:617-667-7981
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2021-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA7767103T00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist