Provider Demographics
NPI:1194927020
Name:NISHMAN, ALAN JODY (LMT)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:JODY
Last Name:NISHMAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 538
Mailing Address - Street 2:23 O'NEIL ROAD
Mailing Address - City:HAYDENVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01039-0538
Mailing Address - Country:US
Mailing Address - Phone:413-586-8105
Mailing Address - Fax:
Practice Address - Street 1:92 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1499
Practice Address - Country:US
Practice Address - Phone:413-586-8105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist