Individual
AMANDA AVITAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3004 146TH ST, FLUSHING, NY 11354-2324
(516) 840-6419
Mailing address
25 SHERWOOD LN, CEDARHURST, NY 11516-2618
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0388067
NY
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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