Basic Information
| Provider Information | |||||||||
| NPI: | 1316269004 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEISS | ||||||||
| FirstName: | NITZA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 509 CATHEDRAL PKWY APT 9B | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100252038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184401113 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 17810 WEXFORD TER | ||||||||
| Address2: | JAMAICA ESTATES | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114323050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186581123 | ||||||||
| FaxNumber: | 7186584641 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2010 | ||||||||
| LastUpdateDate: | 02/22/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 080714-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.