Individual
AMANDA RUTH SATHEESKUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1363 PINE CT, EAST MEADOW, NY 11554-4512
(516) 353-7191
Mailing address
1363 PINE CT, EAST MEADOW, NY 11554-4512
(516) 353-7191
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
309813
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
AG07200135
NY
Other
Enumeration date
12/07/2020
Last updated
07/22/2023
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