Provider Demographics
NPI:1780733113
Name:NINAN, SUNEIL C (DC)
Entity type:Individual
Prefix:DR
First Name:SUNEIL
Middle Name:C
Last Name:NINAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:GOWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14070
Mailing Address - Country:US
Mailing Address - Phone:716-532-6212
Mailing Address - Fax:716-532-6212
Practice Address - Street 1:18 EAST MAIN STREET
Practice Address - Street 2:GOWANDA CHIROPRACTIC
Practice Address - City:GOWANDA
Practice Address - State:NY
Practice Address - Zip Code:14070
Practice Address - Country:US
Practice Address - Phone:716-532-6212
Practice Address - Fax:716-532-6212
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U49125Medicare UPIN
NY232571Medicare ID - Type Unspecified