Individual
AMANDA ISHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1855 CORPORAL KENNEDY ST APT 1D, BAYSIDE, NY 11360-1459
(845) 827-6508
Mailing address
1855 CORPORAL KENNEDY ST APT 1D, BAYSIDE, NY 11360-1459
(845) 827-6508
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
060872
NY
Other
Enumeration date
02/29/2016
Last updated
02/29/2016
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