Individual
AMANDA ANSELME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1260 HOLLY RD, WANTAGH, NY 11793-2619
(646) 899-4595
Mailing address
1260 HOLLY RD, WANTAGH, NY 11793-2619
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
10/27/2025
Last updated
10/27/2025
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