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Individual

AMANDA ACEVEDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
255 EXECUTIVE DR STE LL105, PLAINVIEW, NY 11803-1718
(516) 576-2040
Mailing address
24 CORVETTE RD, SELDEN, NY 11784-1814

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
11/13/2023
Last updated
11/13/2023
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