DR. DONNAH M NICKERSON-RETI (NPI# 1033185640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033185640 |
| Entity Type | Individual |
| Full Name | DR. DONNAH M NICKERSON-RETI |
| Credential | M.D. |
| Practice Address |
55 Fifer Ln Lexington MA 02420-1225 |
| Practice Telephone | 7813081600 |
| Mailing Telephone | 7813081600 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2084P0005X |
Psychiatry & Neurology Specialization: Neurodevelopmental Disabilities |
79871 | MA | Allopathic & Osteopathic Physicians |
| X | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
79871 | MA | Allopathic & Osteopathic Physicians |
| X | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
79871 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA # | BN4238691 | 01 |
| Street Address |
55 FIFER LN |
| City | LEXINGTON |
| State | MA |
| Zip Code | 02420-1225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568958643 | Kristen Gargiulo | Physical Therapist | 57 Bedord Street, Ste 202, Lexington, MA 02420 | 2018-07-02 |
| 1902311616 | Lindsey Nicole Wilcox | Physical Therapist | 57 Bedford St Ste 202, Lexington, MA 02420 | 2017-12-05 |
| 1629590443 | Jeffrey Phillip Winer | Psychologist | 57 Bedford St Ste 230, Lexington, MA 02420 | 2017-07-13 |
| 1235678178 | Rebecca Munini | Counselor | 76 Bedford Street, Suite 12, Office 1, Lexington, MA 02420 | 2017-02-13 |
| 1700332376 | Aretha Cohen | Speech-Language Pathologist | 840 Emerson Gardens Road, Excel Center, Lexington, MA 02420 | 2016-09-01 |
| 1710387915 | Niravkumar Patel | Internal Medicine | 4 Hadley Rd, Lexington, MA 02420 | 2014-08-26 |
| 1316368749 | Triad Adolescent Services | Counselor | 363 Mass Ave, Suite 204, Lexington, MA 02420 | 2014-01-03 |
| 1447698063 | Emily Flier Matteodo | Psychiatry & Neurology | 35 Bedford Street, Suite #6, Lexington, MA 02420 | 2013-06-05 |
| 1780941914 | Varun Kapur | Surgery | 33 York St, Lexington, MA 02420 | 2012-04-12 |
| 1992091433 | Karolyn Mary Franz | Acupuncturist | 238 Bedford St Ste 5, Lexington, MA 02420 | 2011-06-23 |
| Find all providers in zip 02420 | ||||
| Taxonomy Code | 2084P0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician or neurologist who specializes in the diagnosis and management of chronic conditions that affect the developing and mature nervous system such as cerebral palsy, mental retardation and chronic behavioral syndromes, or neurologic conditions. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Psychiatry and Neurology, 2007. http://www.abpn.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Psychiatry and Neurology. A subspecialty certificate for NDN was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Ongoing early discussions regarding proposal. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477636553 | Marian A Swope | Psychiatry & Neurology | 245 Fountain Court, Lexington, KY 40509-1200 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427281807 | Rahim Shafa, Md PC | Psychiatry & Neurology | 189 West Street, Suite 4a, Milford, MA 01757 | 2009-09-01 |
| 1447312814 | Sherman Sol Fox | Psychiatry & Neurology | 65 Newbury St, Danvers, MA 01923-1040 | 2006-12-14 |
| 1629040282 | Alan E Geller | Psychiatry & Neurology | 90 Libbey Pkwy, Weymouth, MA 02189-3100 | 2006-02-07 |
Please comment or provide details below to improve the information on DR. DONNAH M NICKERSON-RETI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.