Provider Demographics
NPI:1811343361
Name:NATHAN, NEERA (MD)
Entity type:Individual
Prefix:
First Name:NEERA
Middle Name:
Last Name:NATHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2549
Mailing Address - Country:US
Mailing Address - Phone:603-742-5556
Mailing Address - Fax:
Practice Address - Street 1:50 MICHELS WAY STE 202
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3431
Practice Address - Country:US
Practice Address - Phone:603-742-5556
Practice Address - Fax:603-742-8668
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA283008207N00000X
MDD98884207N00000X
NH24304207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology