Individual
AMANDA L TULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
177 FORT WASHINGTON AVE, NEW YORK, NY 10032-3733
(212) 305-8923
Mailing address
14 FURWOOD DR, EAST NORTHPORT, NY 11731-3113
(631) 807-1332
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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