Provider Demographics
NPI:1386715878
Name:LOUGHRIDGE, NANCY (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LOUGHRIDGE
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 1:1250 HANCOCK ST FL 9
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4339
Mailing Address - Country:US
Mailing Address - Phone:617-774-0490
Mailing Address - Fax:617-770-0526
Practice Address - Street 1:1250 HANCOCK ST FL 9
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4339
Practice Address - Country:US
Practice Address - Phone:617-774-0490
Practice Address - Fax:617-770-0526
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75871207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0980961-003OtherCIGNA
MAJ31128OtherBLUE CROSS
MA3191311Medicaid
MA728467OtherTUFTS HEALTH PLAN
MA0014812OtherNEIGHBORHOOD HEALTH PLAN
MAG401OtherHARVARD PILGRIM
MA0980961-003OtherCIGNA
MAG03380Medicare UPIN