Individual
AMANDA DOUEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
56 BENNETT AVE APT 5L, NEW YORK, NY 10033-2136
(240) 994-8398
Mailing address
56 BENNETT AVE APT 5L, NEW YORK, NY 10033-2136
(240) 994-8398
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
946837151
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174400000
INDEPENDENT
NY
Enumeration date
12/29/2015
Last updated
12/29/2015
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