Provider Demographics
NPI:1043220460
Name:TOMEI, NINA A (MD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:A
Last Name:TOMEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:775 PARK AVENUE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-659-4000
Mailing Address - Fax:631-659-4048
Practice Address - Street 1:775 PARK AVENUE
Practice Address - Street 2:SUITE 125
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-659-4000
Practice Address - Fax:631-659-4048
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY179589-12080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2C4842OtherHEALTHNET
NYCP153OtherOXFORD
NY01237801Medicaid
NY2698164OtherGHI
NY54751NOtherBLUE CROSS/ BLUE SHIELD
NYE83935Medicare UPIN
NY54751NOtherBLUE CROSS/ BLUE SHIELD