Individual
DR. LEIF GEORGE NORDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
294 N MAIN ST, SUITE 101, EAST LONGMEADOW, MA 01028-1838
(413) 525-1870
(413) 525-3883
Mailing address
294 N MAIN ST, SUITE 101, EAST LONGMEADOW, MA 01028-1838
(413) 525-1870
(413) 525-3883
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
45445
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9732314
—
MA
Enumeration date
01/04/2006
Last updated
03/05/2012
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