Individual
MRS. AMY C BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
23405 MAIN RD, ORIENT, NY 11957-1135
(631) 323-2410
Mailing address
240 MAILER CT, SOUTHOLD, NY 11971-1927
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
477234
NY
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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