Individual
DR. SHIRINE NASSERY NIEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(617) 595-6963
Mailing address
68 SOUTH SERVICE ROAD, SUITE 350, MELVILLE, NY 11747-2358
(516) 945-3000
(516) 945-3131
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
221648
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046540
STATE LICENSE
CT
05
—
1285772285
—
CT
Enumeration date
02/02/2007
Last updated
03/26/2015
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