Provider Demographics
NPI:1235771940
Name:NINAN, SHAINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:
Last Name:NINAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DRISLER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-2431
Mailing Address - Country:US
Mailing Address - Phone:914-483-8428
Mailing Address - Fax:
Practice Address - Street 1:1511 ROUTE 22 STE A
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4020
Practice Address - Country:US
Practice Address - Phone:845-278-5251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist