Individual
AMANDA ELYSE MARENGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3005 WATKINS RD, HORSEHEADS, NY 14845-1800
(607) 739-8711
(607) 796-2566
Mailing address
3005 WATKINS RD, HORSEHEADS, NY 14845-1800
(607) 739-8711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
016744
NY
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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