Provider Demographics
NPI:1548257447
Name:NARDIN, RACHEL AUSTEN (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:AUSTEN
Last Name:NARDIN
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 1:174 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4024
Mailing Address - Country:US
Mailing Address - Phone:617-820-4275
Mailing Address - Fax:
Practice Address - Street 1:174 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4024
Practice Address - Country:US
Practice Address - Phone:617-820-4275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81165101YM0800X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA762215OtherTUFTS
MA3159311Medicaid
MA762215OtherTUFTS
MA3159311Medicaid