Healthcare Provider Details

I. General information

NPI: 1801697156
Provider Name (Legal Business Name): LIZABETH LAWRENCE NESHIWAT D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 MIDLAND AVE
YONKERS NY
10704-1092
US

IV. Provider business mailing address

909 MIDLAND AVE
YONKERS NY
10704
US

V. Phone/Fax

Practice location:
  • Phone: 914-562-1340
  • Fax:
Mailing address:
  • Phone: 914-562-1340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number065556
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: