Individual
AMANDA CANCEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
162 ADA DR, STATEN ISLAND, NY 10314-1403
(917) 417-1140
Mailing address
162 ADA DR, STATEN ISLAND, NY 10314-1403
(917) 417-1140
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
788870
NY
Other
Enumeration date
07/15/2026
Last updated
07/15/2026
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