Provider Demographics
NPI:1689748170
Name:NINO MEDICAL ASSOCIATES P.C.
Entity Type:Organization
Organization Name:NINO MEDICAL ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:NINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-938-7000
Mailing Address - Street 1:87 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:PA
Mailing Address - Zip Code:15419-1127
Mailing Address - Country:US
Mailing Address - Phone:724-938-7054
Mailing Address - Fax:
Practice Address - Street 1:87 3RD ST
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:PA
Practice Address - Zip Code:15419-1127
Practice Address - Country:US
Practice Address - Phone:724-938-7000
Practice Address - Fax:724-938-3390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039690-L173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA458599Medicare ID - Type Unspecified