Individual
ANTHONISIA STREETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601B W WASHINGTON ST, GENEVA, NY 14456-2119
(315) 781-8448
(315) 781-8444
Mailing address
14 MAIDEN LN, PENN YAN, NY 14527-1208
(315) 531-9102
(315) 531-9103
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029279
LICENSE
NY
Enumeration date
09/14/2016
Last updated
10/13/2016
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