Provider Demographics
NPI:1114642386
Name:NIEVES, STEVEN JOSEPH (MT-BC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JOSEPH
Last Name:NIEVES
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 BERGEN AVE APT 16C
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3875
Mailing Address - Country:US
Mailing Address - Phone:732-589-1699
Mailing Address - Fax:
Practice Address - Street 1:86 BERGEN AVE APT 16C
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3875
Practice Address - Country:US
Practice Address - Phone:732-589-1699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13222225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist