Provider Demographics
NPI:1740047075
Name:REIS, NINA ELIZABETH
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:ELIZABETH
Last Name:REIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 JAMAICA ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3819
Mailing Address - Country:US
Mailing Address - Phone:508-280-7914
Mailing Address - Fax:
Practice Address - Street 1:32 JAMAICA ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3819
Practice Address - Country:US
Practice Address - Phone:508-280-7914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist