Individual
AMY STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 VALLEY DR, SYRACUSE, NY 13207-2298
(315) 468-1632
Mailing address
4277 MONTEZUMA CRSE, LIVERPOOL, NY 13090-6854
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
725427131
NY
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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