Provider Demographics
NPI:1669173415
Name:FLEETER, ABBIE
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:
Last Name:FLEETER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1726
Mailing Address - Country:US
Mailing Address - Phone:516-495-4898
Mailing Address - Fax:
Practice Address - Street 1:77 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1726
Practice Address - Country:US
Practice Address - Phone:516-495-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program