Jerry Ninia M.D.

NPI # 

Practice Address:

4 Roosevelt Ave

Port Jefferson Station, NY, 11776-3363

Practice Phone:

631-331-0500

Practice Fax:

631-331-1644

License Number:

174810

License State:

NY

Taxonomy Grouping:

Allopathic & Osteopathic Physicians

Taxonomy Classification:

Obstetrics & Gynecology

Taxonomy Code:

207V00000X

Deactivation Date:

2006-03-20T00:00:00.000Z

Deactivation Code:

None

Reactivation Date:

2006-03-29T00:00:00.000Z

Updated by NPPES on 4/27/2017. You can view the original data set for NPI # 1457350795 on the official NPPES website. If the information about this NPI provider/company is outdated you can request updates through the NPPES website. See our FAQ page for more information.

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Jerry Ninia , M.D. 's

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Jerry Ninia , M.D. 's

CMS prescription data

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