Individual
AMANDA ROSALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
263 BLUE POINT AVE, BLUE POINT, NY 11715-1224
(631) 419-6737
(631) 868-3498
Mailing address
359 BOULDER ST, RONKONKOMA, NY 11779-4908
(631) 676-5383
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311586-1
NY
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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