Provider Demographics
NPI:1780880385
Name:SIEGEL, NICOLE HAUPTMAN (MD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:HAUPTMAN
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:ESTHER
Other - Last Name:HAUPTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2005 BAY ST STE 206
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-1085
Mailing Address - Country:US
Mailing Address - Phone:508-823-7473
Mailing Address - Fax:508-824-3830
Practice Address - Street 1:2005 BAY ST STE 206
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-1085
Practice Address - Country:US
Practice Address - Phone:508-823-7473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA246724207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist