Individual
MISS AMANTHA THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
531 E LINCOLN AVE APT 4N, MOUNT VERNON, NY 10552-3743
(718) 920-9000
Mailing address
531 E LINCOLN AVE APT 4N, MOUNT VERNON, NY 10552-3743
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN9364653
FL
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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