Provider Demographics
NPI:1386286169
Name:WYNTER, NADINE
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:WYNTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 SYLVESTER ST
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-3957
Mailing Address - Country:US
Mailing Address - Phone:516-503-9381
Mailing Address - Fax:
Practice Address - Street 1:207 SYLVESTER ST
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-3957
Practice Address - Country:US
Practice Address - Phone:516-503-9381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-12
Last Update Date:2019-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide