Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Nina Michelle Fagan

Individual provider Specialist · NPI 1124389036

Mrs. Nina Michelle Fagan is a Specialist in Manorville, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012
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Practice location Address checks out

42 Oceanview Blvd
Manorville, NY 11949-2956
Phone: (516) 356-3716
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 1766626 (NY)

Record details

NPI number1124389036
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 6, 2012
Last updated in NPPESJune 6, 2012

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