Provider Demographics
NPI:1801994736
Name:FEINGOLD-PALMER, NANCY (PHD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:FEINGOLD-PALMER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SAXON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON HIGHLANDS
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:246 WALNUT ST
Practice Address - Street 2:SUITE 104
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02460-1689
Practice Address - Country:US
Practice Address - Phone:617-244-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2622103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA596183Medicaid
MAW02721OtherBCBS
MAW02721OtherBCBS