Shaine Easo Ninan, PHARM D, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI04204500 Issued in NJ

Practice address

470 Pleasant Valley Way
West Orange, NJ 07052-2802

Phone

(973) 500-4430

NPI assigned

Feb 1, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eagle Rock Pharmacy LLC

  • Community/Retail Pharmacy
  • West Orange, NJ
  • NPI 1649832684
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1942953740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DRISLER AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106072431",
            "telephone_number": "718-295-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522802",
            "telephone_number": "973-500-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINAN",
        "first_name": "SHAINE",
        "middle_name": "EASO",
        "name_prefix": "Dr.",
        "credential": "PHARM D, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04204500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany NG, PHARMD
• Pascaline Ngu
• Anthony Nicotera, J.D., DSW, LCSW
• Theodore A Niebloom, DMD
• Jeremiah David Nieves, M.D.
• NJ Allergy MD, LLC
• NJ Endovascular & Amputation Prevention LLC
• NJ Multi-Disciplinary Medical Associates LLC
• NJ Spine and Brain Surgery
• NJ Spine&Pain Institute

• Pharmacist in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.