Individual
ANAELLE AMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
40 CRANBERRY ST, CENTRAL ISLIP, NY 11722-4922
(718) 200-5983
Mailing address
40 CRANBERRY ST, CENTRAL ISLIP, NY 11722-4922
(718) 200-5983
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
775690
NY
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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