Active NPI
Mina Nan
- Student in an Organized Health Care Education/Training Program
- Bayonne, NJ
National Provider Identifier
1669358172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 214 Avenue a Apt B1
Bayonne, NJ 07002-1271 - Phone
- (551) 312-8177
- NPI assigned
- Aug 12, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
214 Avenue a Apt B1
Bayonne, NJ 07002-1271
Mailing address
214 Avenue a Apt B1
Bayonne, NJ 07002-1271
Phone (551) 312-8177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Interoperability endpoints
- mina.nan.1@12833.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754956800000",
"number": "1669358172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 AVENUE A APT B1",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070021271",
"telephone_number": "551-312-8177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 AVENUE A APT B1",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070021271",
"telephone_number": "551-312-8177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAN",
"first_name": "MINA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-08-12",
"last_updated": "2025-08-12",
"certification_date": "2025-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bayonne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.