Provider Demographics
NPI:1598872731
Name:VERMA, NITIN (MD,FACC)
Entity type:Individual
Prefix:
First Name:NITIN
Middle Name:
Last Name:VERMA
Suffix:
Gender:M
Credentials:MD,FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W 6TH ST STE 280
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2551
Mailing Address - Country:US
Mailing Address - Phone:315-349-5752
Mailing Address - Fax:315-349-5769
Practice Address - Street 1:140 W 6TH ST STE 280
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2551
Practice Address - Country:US
Practice Address - Phone:315-349-5752
Practice Address - Fax:315-349-5769
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296449207RC0000X, 207RC0000X
PAMD435977207RC0000X, 207RC0000X
NHLT4118207RC0000X
MEMD22458207RC0000X
VA0101260788207RC0000X, 208M00000X
MDD66327207RC0000X
MO2014012496207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102467489Medicaid
MO1598872731Medicaid
PA1007278000OtherMEDICAID GROUP TPI
WI100086836Medicaid
PACD4829OtherRAILROAD MEDICARE TPI GROUP
PA037276OtherMLHC MEDICARE AA #
PA597586OtherMEDICARE GROUP TPI
PACD4829OtherRAILROAD MEDICARE TPI GROUP