Provider Demographics
NPI:1477554251
Name:NIELSEN, STEVEN A (MD)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:A
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3075
Mailing Address - Country:US
Mailing Address - Phone:781-740-8874
Mailing Address - Fax:
Practice Address - Street 1:300 CONGRESS ST
Practice Address - Street 2:SUITE 201
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0907
Practice Address - Country:US
Practice Address - Phone:617-471-5665
Practice Address - Fax:617-471-7041
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78177207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
015778OtherHARVARD/PILGRIM
J13880OtherBCBS
3112314OtherMASS HEALTH
3112314OtherMASS HEALTH
E84202Medicare UPIN