Individual
AMANDA AGOSTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 BINGHAM PL, AMITYVILLE, NY 11701-4218
(631) 889-2585
Mailing address
15 BINGHAM PL, AMITYVILLE, NY 11701-4218
(631) 889-2585
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
388450101
NY
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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