Provider Demographics
NPI:1821248386
Name:DAYEN, NINA (DO)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:DAYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 E 13TH ST APT 4H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1932
Mailing Address - Country:US
Mailing Address - Phone:347-587-6814
Mailing Address - Fax:
Practice Address - Street 1:93-40 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-730-9213
Practice Address - Fax:718-730-9329
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250014207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G400001731Medicare UPIN