Provider Demographics
NPI:1265625750
Name:SIDERI, NANCY A (HIS)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:A
Last Name:SIDERI
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MERRIMAC
Mailing Address - State:MA
Mailing Address - Zip Code:01860-2005
Mailing Address - Country:US
Mailing Address - Phone:978-346-4400
Mailing Address - Fax:978-346-0676
Practice Address - Street 1:5 E MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:MERRIMAC
Practice Address - State:MA
Practice Address - Zip Code:01860-2005
Practice Address - Country:US
Practice Address - Phone:978-346-4400
Practice Address - Fax:978-346-0676
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA186-1237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist