Healthcare Provider Details

I. General information

NPI: 1013590884
Provider Name (Legal Business Name): NISREEN SHLEIWET DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 NELSON AVE
HARRISON NY
10528-3203
US

IV. Provider business mailing address

60 ALONA DR
MAHOPAC NY
10541-1037
US

V. Phone/Fax

Practice location:
  • Phone: 914-714-1937
  • Fax:
Mailing address:
  • Phone: 914-714-1937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number013469
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number013469
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: