Provider Demographics
NPI:1871898049
Name:NESHEIWAT, ANNA ELISA (ELISA NESHEIWAT)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:ELISA
Last Name:NESHEIWAT
Suffix:
Gender:F
Credentials:ELISA NESHEIWAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 FAIR ST
Mailing Address - Street 2:FAIR STREET
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-6141
Mailing Address - Country:US
Mailing Address - Phone:845-225-2611
Mailing Address - Fax:
Practice Address - Street 1:664 STONELEIGH AVEENUE
Practice Address - Street 2:PUTNAM HOSPITAL CENTER
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-6141
Practice Address - Country:US
Practice Address - Phone:845-279-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9063225100000X
NY021222-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist