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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JERRY NINIA, M.D.

Deactivated Sole Proprietor

DR. JERRY NINIA, M.D. is a Obstetrics & Gynecology healthcare provider located in PORT JEFFERSON STATION, New York. NPI 1457350795 is deactivated in the NPPES registry. Verify at CMS.

Obstetrics & Gynecology · PORT JEFFERSON STATION, NY

This NPI has been deactivated. The record was deactivated on March 20, 2006. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1457350795
Provider Type
Individual
Gender
Male
NPI Issued
Jul 19, 2005 (0.66849315068493 yrs)
Last Updated
Apr 27, 2017
Deactivated
Mar 20, 2006
Licenses
174810 (NY)
174810 (NY)
Sole Proprietor
Yes

Practice Information

Address
4 ROOSEVELT AVE
PORT JEFFERSON STATION, NY, 117763363
Browse NY providers · Browse ZIP 11776
Phone
6313310500
Fax
6313311644
Primary Specialty
Obstetrics & Gynecology
207V00000X
Additional Specialty
202K00000X

Other Obstetrics & Gynecology Providers in PORT JEFFERSON STATION, NY

Name Credential NPI
DR. DANA L BRENNER MD 1902850878
GUSTAVO SANROMAN M.D. 1619917960
DR. THOMAS P. ERHART D.O. 1508891425
THEODORE GOLDBERG M.D. 1750468435
DREUX PATTON M.D. 1699852384
DR. FARZANA MOHAMED GARCIA DO 1891130902
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.