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Individual

MISS AMANDA M GALLOWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.N

Contact information

Practice address
470 STARLIGHT DR, SHIRLEY, NY 11967-1221
(631) 775-8718
Mailing address
470 STARLIGHT DR, SHIRLEY, NY 11967-1221
(631) 775-8718

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303889-1
NY

Other

Enumeration date
10/27/2011
Last updated
10/27/2011
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