Provider Demographics
NPI:1679169445
Name:STREETE, NEISHA
Entity type:Individual
Prefix:
First Name:NEISHA
Middle Name:
Last Name:STREETE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 RYE RIDGE PLZ # 335
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 RYE RIDGE PLZ # 335
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2822
Practice Address - Country:US
Practice Address - Phone:347-202-8036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0269271225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist