Provider Demographics
NPI:1144649575
Name:JOSEPH, NANCY I (DO)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:I
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 STATE ST FL 26
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-1827
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 STATE ST FL 26
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-1827
Practice Address - Country:US
Practice Address - Phone:617-204-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.013012207K00000X
IL036.174806207K00000X
MA281421207K00000X, 208D00000X
NY297572207K00000X
MN76966207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice