Provider Demographics
NPI:1912920216
Name:PALMER, NINA A (MD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:A
Last Name:PALMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name Type:
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Mailing Address - Street 1:230 WORCESTER ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5420
Mailing Address - Country:US
Mailing Address - Phone:781-431-5270
Mailing Address - Fax:781-431-5535
Practice Address - Street 1:230 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-5420
Practice Address - Country:US
Practice Address - Phone:781-431-5270
Practice Address - Fax:781-431-5535
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA490552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ02364OtherBLUE CROSS
MA049055OtherTUFTS HEALTH PLAN
MA0017370OtherNEIGHBORHOOD HEALTH PLAN
MA049055OtherTUFTS HEALTH PLAN
MAA56559Medicare UPIN