Provider Demographics
NPI:1316947203
Name:KLEINBERG, NINA J (CNM)
Entity type:Individual
Prefix:MS
First Name:NINA
Middle Name:J
Last Name:KLEINBERG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WESTERN MASS PHYSICIAN ASSOCIATES INC
Mailing Address - Street 2:260 NEW LUDLOW RD
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020
Mailing Address - Country:US
Mailing Address - Phone:413-533-3470
Mailing Address - Fax:413-533-6859
Practice Address - Street 1:230 MAPLE STREET
Practice Address - Street 2:SUITE 200 MIDWIFERY CARE OF HOLYOKE
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040
Practice Address - Country:US
Practice Address - Phone:413-535-4700
Practice Address - Fax:413-535-4704
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA188294367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
043202198008OtherTRICARE
188294OtherCONNECTICARE OF MA
043202198OtherGROUP PRACTICE ENROLLMENT
21220008695OtherBEECH STREET
CN0091OtherBLUE CROSS/BLUE SHIELD
043202198OtherHEALTH CARE VALUE MANAGEM
043202198OtherMULTI-PLAN
MA0356956Medicaid
043202198OtherCIGNA