Provider Demographics
NPI:1649487844
Name:NESHEIWAT, JANETTE (MD)
Entity type:Individual
Prefix:DR
First Name:JANETTE
Middle Name:
Last Name:NESHEIWAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 PAR LN
Mailing Address - Street 2:APT 101
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-5619
Mailing Address - Country:US
Mailing Address - Phone:410-236-7809
Mailing Address - Fax:
Practice Address - Street 1:1345 RXR PLZ
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11556-1301
Practice Address - Country:US
Practice Address - Phone:516-783-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275185207Q00000X
AR390200000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR172976001Medicaid
AR5H292Medicare PIN