NIENKE PRINS DOSA MD NPI 1063435774

NPI Information

  • NPI: 1063435774
  • Provider Name: NIENKE PRINS DOSA, MD
  • Classification: Pediatrics - 2080P0008X
  • Specialization: Neurodevelopmental Disabilities
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 725 IRVING AVE
    CROUSE POB
    SYRACUSE, NY
    ZIP 13210
  • Phone: (315) 464-4842

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NPI Details

Nienke Prins Dosa, MD is a neurodevelopmental disabilities pediatrics in Syracuse, NY. The provider is a pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. Nienke Prins Dosa, MD NPI is 1063435774. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

725 IRVING AVE
CROUSE POB
SYRACUSE, NY
ZIP 13210-603
Phone: (315) 464-4842
Fax: (315) 464-7564

The NPI 1063435774 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 9/14/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0008XPediatricsNeurodevelopmental Disabilities205943NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1J400009704MEDICARE PINNEW YORK
2H56613MEDICARE UPINNEW YORK
302242377MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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