Individual
AMY IMKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1882 CHARLES ST, MERRICK, NY 11566-4517
(516) 868-1609
Mailing address
1882 CHARLES ST, MERRICK, NY 11566-4517
(516) 868-1609
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
158679
NY
Other
Enumeration date
12/07/2012
Last updated
12/07/2012
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