Individual
AMANDA MEDVEDOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
647 LAMOKA AVE, STATEN ISLAND, NY 10312-3435
(718) 494-1715
Mailing address
647 LAMOKA AVE, STATEN ISLAND, NY 10312-3435
(718) 494-1715
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
33338583
NY
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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