Individual
AMANDA PEZZULO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, BA
Contact information
Practice address
210 BALLSTON AVE, BALLSTON SPA, NY 12020-3606
(518) 884-7200
Mailing address
210 BALLSTON AVE, BALLSTON SPA, NY 12020-3606
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
702920
NY
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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