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ROBERT S NISSAN M.D.
NPI 1669479010
Family Medicine in Northport, NY

Active since June 30, 2005
325 MAIN ST, NORTHPORT, NY 11768(631) 261-4445(631) 261-3710 Get Directions Write a Review

NPPES record last updated: March 24, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Robert S Nissan M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROBERT S NISSAN M.D. (NPI 1669479010) is an individual family medicine provider in Northport, New York, licensed in New York (131824) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1669479010
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameROBERT S NISSANCredential: M.D.
Location Address325 MAIN STNorthport, NY 11768-1790
Mailing Address325 Main StNorthport, NY 11768-1790 · (631) 261-4445 · Fax (631) 261-3710
Phone(631) 261-4445
Fax(631) 261-3710
Sole ProprietorNo
Enumeration DateJune 30, 2005
Last NPPES UpdateMarch 24, 2010
✔ NPI 1669479010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 131824
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
325 MAIN ST, Northport, NY 11768
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Other Identifiers 11

Other24A921NY · Medicare Legacy
Other442081060NY · Medicare Railroad Ptan
Other0065892Ghi
Other1C2496Healthnet
OtherCP521Oxford
Medicare UPINB11357
Other0520035Aetna
Medicaid00590001NY
Other10263Vytra
Other24A921NY · Blue Cross Blue Shield
Medicare PINA400001677NY

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAREN L OLIVIERI P.A.
Physician Assistant
325 MAIN ST
NORTHPORT, NY 11768
Suffolk County (631) 261-4445
ALAN R LAMPERT M.D.
Family Medicine
325 MAIN ST
NORTHPORT, NY 11768
Suffolk County (631) 261-4445
JOHN SAMMIS D.O.
Family Medicine
325 MAIN ST
NORTHPORT, NY 11768
Suffolk County (631) 230-2030
STEVEN E KLEIN M.D.
Family Medicine
325 MAIN ST
NORTHPORT, NY 11768
Suffolk County (631) 261-4445
NORTHPORT FAMILY MEDICINE P.C
Family Medicine
325 MAIN ST
NORTHPORT, NY 11768
Suffolk County (631) 261-4445
BERNADETTE DUBE
Nurse Practitioner (Family)
325 MAIN ST
NORTHPORT, NY 11768
Suffolk County (631) 261-4445

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert Nissan's NPI number?

The NPI number for Robert Nissan is 1669479010. It was assigned to this individual provider in the NPPES registry on June 30, 2005.

Where is Robert Nissan located?

Robert Nissan practices at 325 Main St, Northport, NY 11768. The listed phone number is (631) 261-4445.

What is Robert Nissan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Robert Nissan was last updated on March 24, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.