Individual
LENMARA AMETOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
39 LOMBARD CT, STATEN ISLAND, NY 10312-1671
(646) 670-2947
Mailing address
39 LOMBARD CT, STATEN ISLAND, NY 10312-1671
(646) 670-2947
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
690171
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
690171
LICENSE
NY
Enumeration date
04/28/2021
Last updated
04/28/2021
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