Individual
AMANDA LITTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
45 LAKESIDE DR, LAKE RONKONKOMA, NY 11779-1949
(631) 948-1011
Mailing address
45 LAKESIDE DR, LAKE RONKONKOMA, NY 11779-1949
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
302146
NY
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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