Individual
AMY CONGLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
320 BURLINGHAM RD, PINE BUSH, NY 12566-6817
(845) 699-4432
Mailing address
320 BURLINGHAM RD, PINE BUSH, NY 12566-6817
(845) 699-4432
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
302937-1
NY
Other
Enumeration date
11/09/2011
Last updated
11/09/2011
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