Individual
DR. NITHYA GOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 ROUTE 112, BLDG 11, SUITE A, PORT JEFFERSON STATION, NY 11776-8054
(631) 331-1120
Mailing address
1500 ROUTE 112, BLDG 11, SUITE A, PORT JEFFERSON STATION, NY 11776-8054
(631) 331-1120
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
288944
NY
207VX0000X
Obstetrics Physician
16440
NV
Other
Enumeration date
05/01/2015
Last updated
04/08/2025
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