Provider Demographics
NPI:1689970790
Name:NINAN, NEIL ABRAHAM (MD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:ABRAHAM
Last Name:NINAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 RTE 37 W FL 3
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6400
Mailing Address - Country:US
Mailing Address - Phone:732-818-3811
Mailing Address - Fax:732-818-3820
Practice Address - Street 1:67 RTE 37 W FL 3
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6400
Practice Address - Country:US
Practice Address - Phone:732-557-8000
Practice Address - Fax:732-818-3820
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-00266207RP1001X
NJ25MA12372600207RP1001X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease