Provider Demographics
NPI:1811306921
Name:MANIPON, NINA A (ND)
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:A
Last Name:MANIPON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 PROGRESS DR STE 218C
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3600
Mailing Address - Country:US
Mailing Address - Phone:201-362-3166
Mailing Address - Fax:
Practice Address - Street 1:76 PROGRESS DR STE 218C
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3600
Practice Address - Country:US
Practice Address - Phone:201-362-3166
Practice Address - Fax:888-393-5361
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT519175F00000X
CT000519175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath