Provider Demographics
NPI:1255583811
Name:STEELE, BRENDA EILEEN (LMT)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:EILEEN
Last Name:STEELE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14787-1401
Mailing Address - Country:US
Mailing Address - Phone:716-326-4436
Mailing Address - Fax:
Practice Address - Street 1:121 S PORTAGE ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NY
Practice Address - Zip Code:14787-1429
Practice Address - Country:US
Practice Address - Phone:716-326-4995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004989172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist