Individual
MISS AMANDA REBEKAH MAYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
24 WILSON AVENUE, MIDDLE ISLAND, NY 11953
(631) 599-4077
Mailing address
24 WILSON AVE, MIDDLE ISLAND, NY 11953-1858
(631) 599-4077
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
330239
NY
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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