MEDICARE: MS. NEYSHA MICHEALA-ALITHE FLETCHER-KWENTUA P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	006716-1	NY

General Provider Information

NPI Number	:	1194865816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NEYSHA MICHEALA-ALITHE FLETCHER-KWENTUA P.A.

Provider Business Mailing Address
First Line	:	224A STRAWTOWN RD
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-6827
Country	:	US
Telephone Number	:	347-393-8814
Fax Number	:

Provider Business Practice Location Address
First Line	:	506 MALCOLM X BLVD
Second Line	:	MLK PAV., 17TH FLOOR, RM 17101
City	:	NEW YORK
State	:	NY
Zip	:	10037-1802
Country	:	US
Telephone Number	:	212-939-4001
Fax Number	:	212-939-4015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	12/16/2025

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