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

Nikita Shmyrin

Individual provider Physician Assistant · NPI 1477273613

Nikita Shmyrin is a Physician Assistant in Stony Brook, New York. Licensed in New York. Registered with an NPI since 2022.

Licensed in
NY
In the registry since
2022

Practice location Address checks out

21 Valley Rd
Stony Brook, NY 11790-1615
Phone: (516) 595-4252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 028767 (NY)

Record details

NPI number1477273613
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 29, 2022
Last updated in NPPESAugust 29, 2022
Certification dateAugust 19, 2022
Mailing address21 Valley Rd, Stony Brook, NY 11790-1615

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