Individual
AMANDA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
410 LAKEVILLE RD, NEW HYDE PARK, NY 11042-1101
(516) 992-5219
Mailing address
1656 FAIRFAX AVE, WEST ISLIP, NY 11795-1329
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F383492
NY
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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