Individual
AMY C EXRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 W 67TH ST, NEW YORK, NY 10023-6237
(212) 799-6700
(212) 799-4533
Mailing address
11 W 67TH ST, NEW YORK, NY 10023-6237
(212) 799-6700
(212) 799-4533
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
032729
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032729
LICENCE NUMBER
NY
Enumeration date
11/04/2010
Last updated
11/04/2010
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