Individual
MS. AMANDA MOGLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
30 LAKESIDE LN, WESTHAMPTON, NY 11977-1239
(631) 831-3447
Mailing address
30 LAKESIDE LN, WESTHAMPTON, NY 11977-1239
(631) 831-3447
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
320335
NY
Other
Enumeration date
01/15/2015
Last updated
01/15/2015
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