Individual
AMANDA CERVINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
34 WENWOOD DR, HAUPPAUGE, NY 11788-4321
(631) 624-1763
Mailing address
34 WENWOOD DR, HAUPPAUGE, NY 11788-4321
(631) 624-1763
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
31683-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M00D22842
—
NY
Enumeration date
01/28/2015
Last updated
01/28/2015
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