Individual
AMANDA PAVIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 WITTEMAN PL, STATEN ISLAND, NY 10301-4627
(646) 645-5644
Mailing address
4 WITTEMAN PL, STATEN ISLAND, NY 10301-4627
(646) 645-5644
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/03/2021
Last updated
01/03/2021
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