Basic Information
| Provider Information | |||||||||
| NPI: | 1093031072 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUKE | ||||||||
| FirstName: | NINA | ||||||||
| MiddleName: | NIAMKEY | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | NIAMKEY | ||||||||
| OtherFirstName: | NINA | ||||||||
| OtherMiddleName: | AMA | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 37215 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212973215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024763670 | ||||||||
| FaxNumber: | 2024764741 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 S 7TH AVE | ||||||||
| Address2: | SUITE 3170 | ||||||||
| City: | WEST READING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196111410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108989380 | ||||||||
| FaxNumber: | 6104781170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2010 | ||||||||
| LastUpdateDate: | 09/30/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD041522 | DC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.