Individual
AMANDA STASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
20 OLD TURNPIKE RD, NANUET, NY 10954-2532
(845) 624-0260
Mailing address
490 TALLY HO RD, MIDDLETOWN, NY 10940-7331
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
332228-1
NY
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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