Individual
AMANDA SAMAAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 LEONELLO LN, STATEN ISLAND, NY 10307-2412
(347) 996-9935
Mailing address
15 LEONELLO LN, STATEN ISLAND, NY 10307-2412
(347) 996-9935
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
22DI02919200
NJ
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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