Individual
AMBERLY ADIAZ LAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-8660
Mailing address
57 CONSTITUTION ST, WALLINGFORD, CT 06492-3824
(203) 640-7020
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/19/2023
Last updated
05/02/2023
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