Individual
AMANDA SHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 E 69TH ST, 5D, NEW YORK, NY 10021-5471
(617) 939-7777
Mailing address
201 E 69TH ST, 5D, NEW YORK, NY 10021-5471
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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