Individual
AMANDA NANNETTE KAMINARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795
(631) 376-3000
Mailing address
642 WADING RIVER HOLLOW RD, RIDGE, NY 11961-2316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022134-1
NY
Other
Enumeration date
09/05/2018
Last updated
09/06/2018
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