Individual
MISS AMANDA PAOLA VALENCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
10114 39TH AVE, 1ST FLOOR, CORONA, NY 11368-4805
(718) 639-3102
Mailing address
4120 46TH ST APT 4F, SUNNYSIDE, NY 11104-1834
(718) 786-6643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
012220
NY
Other
Enumeration date
11/17/2007
Last updated
08/26/2013
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