Individual
AMANDA ERAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6582 160TH ST, FRESH MEADOWS, NY 11365-2562
(646) 709-6645
Mailing address
265 BROADHOLLOW RD STE MELVILLE, MELVILLE, NY 11747-4833
(888) 722-2072
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
341713
NY
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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