Individual
AMANDA MARIE BUZOLICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC,OCN,CHPN,
Contact information
Practice address
120 MINEOLA BLVD STE 500, MINEOLA, NY 11501-4074
(516) 663-9500
Mailing address
120 MINEOLA BLVD STE 500, MINEOLA, NY 11501-4074
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
713309-1
NY
163W00000X
Registered Nurse
9300321
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
309947
NY
Other
Enumeration date
07/27/2018
Last updated
10/24/2024
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