National Provider Identifier
Mitchell Derrick Streety
Mitchell Derrick Streety is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Orchard Park, NY and a listed phone number of (716) 544-2991.
Profile Overview
- NPI
- 1194463034
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- May 20, 2022
- Last Updated
- May 20, 2022
Practice Location
- 95 Fox Meadow Ln
- Orchard Park, NY 14127-2885
Phone: (716) 544-2991
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1194463034
- Entity Type
- Individual
- Last Name
- Streety
- First Name
- Mitchell
- Middle Name
- Derrick
- Name Prefix
- Mr.
- Mailing Street Address
- 95 Fox Meadow Ln
- Mailing City
- Orchard Park
- Mailing State
- NY
- Mailing ZIP Code
- 14127-2885
- Mailing Country
- US
- Mailing Phone
- (716) 544-2991
- Practice Street Address
- 95 Fox Meadow Ln
- Practice City
- Orchard Park
- Practice State
- NY
- Practice ZIP Code
- 14127-2885
- Practice Country
- US
- Practice Phone
- (716) 544-2991
- Enumeration Date
- May 20, 2022
- Last Updated
- May 20, 2022
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- May 20, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)