Individual
DR. CARMELO MICHAEL NINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
2299 JACKSON AVE, SEAFORD, NY 11783-3223
(516) 426-8904
Mailing address
2299 JACKSON AVE, SEAFORD, NY 11783-3223
(516) 426-8904
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
017821
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017821
PSYCHOLOGIST LICENSE
NY
Enumeration date
04/29/2009
Last updated
01/08/2021
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