Individual
AMBER LEE BRAZEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
137 HINSDALE RD, MATTYDALE, NY 13211-1207
(315) 882-8640
Mailing address
137 HINSDALE RD, MATTYDALE, NY 13211-1207
(315) 882-8640
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10 274384
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02728756
—
NY
Enumeration date
07/14/2010
Last updated
07/14/2010
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