Provider Demographics
NPI:1942953740
Name:NINAN, SHAINE EASO (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:SHAINE
Middle Name:EASO
Last Name:NINAN
Suffix:
Gender:M
Credentials:PHARM D, RPH
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:718-295-8289
Mailing Address - Fax:
Practice Address - Street 1:470 PLEASANT VALLEY WAY
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2802
Practice Address - Country:US
Practice Address - Phone:973-500-4430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04204500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist