Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 244489 | MA |
N | 111NI0900X | Internist | 244489 | MA |
N | 207RH0003X | Hematology & Oncology | 20349 | NH |
Y | 207RH0003X | Hematology & Oncology | MD21087 | ME |
NPI | 1023339819 |
---|---|
Provider Name | Dr. Eleni Nicole Nackos |
First Address | Brattleboro, VT 05302-0911 |
Second Address | Topsham, ME 04086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2010 |
Last Update Date | 30/03/2021 |