Individual
AMANDA MINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 OLD COUNTRY RD STE 103N, WESTBURY, NY 11590-5119
(516) 806-6969
Mailing address
116 BLUEBERRY LN, HICKSVILLE, NY 11801-4536
(516) 761-2612
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1599084221
NY
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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