Provider Demographics
NPI:1235282419
Name:GEORGES, NICK GEORGE (BARBER)
Entity type:Individual
Prefix:MR
First Name:NICK
Middle Name:GEORGE
Last Name:GEORGES
Suffix:
Gender:M
Credentials:BARBER
Other - Prefix:MR
Other - First Name:NICHOLAS
Other - Middle Name:GEORGE
Other - Last Name:GEORGES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BARBER
Mailing Address - Street 1:130 SYLVAN ST DANVERS MA 01923
Mailing Address - Street 2:SUITE 5
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3675
Mailing Address - Country:US
Mailing Address - Phone:978-750-8200
Mailing Address - Fax:978-750-4010
Practice Address - Street 1:130 SYLVAN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3675
Practice Address - Country:US
Practice Address - Phone:978-750-8200
Practice Address - Fax:978-750-4010
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16237224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA703485OtherHARVARD PILGRIM
MA363354OtherBLUE CROSS BLUE SHIELD