Individual
AMY VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1419 SALT SPRINGS RD, DE WITT, NY 13214-1301
(315) 445-4100
Mailing address
44 E 17TH ST, HUNTINGTON STATION, NY 11746-2915
(516) 749-5621
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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