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Mr. Mitchell Derrick Streety
Student in an Organized Health Care Education/Training Program in Orchard Park, New York
NPI 1194463034

Mitchell Derrick Streety is a Student in an Organized Health Care Education/Training Program based in Orchard Park, NY. Mitchell Derrick Streety practices in Orchard Park, NY. The NPI Number for Mitchell Derrick Streety is 1194463034 and holds a License No. (New York).

The current practice location address for Mitchell Derrick Streety is 95 Fox Meadow Ln, Orchard Park, NY and can be reached out via phone at 716-544-2991.

Location: 95 Fox Meadow Ln, Orchard Park, NY, 14127-2885
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194463034
Provider Name
Mitchell Derrick Streety
Credential
Provider Entity Type
Individual
Gender
Male
Address
95 Fox Meadow Ln, Orchard Park, NY, 14127-2885
Phone Number
716-544-2991
Fax Number
Provider Enumeration Date
05/20/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
95 Fox Meadow Ln
City
Orchard Park
State
New York
Zip
14127-2885
Phone Number
716-544-2991
Fax Number
person
Provider Business Mailing Address Details
Address
95 Fox Meadow Ln
City
Orchard Park
State
New York
Zip
14127-2885
Phone Number
716-544-2991
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(New York)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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