Individual
AMANDA R HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13 FLINTLOCK DR, SHIRLEY, NY 11967-2616
(631) 687-9886
Mailing address
13 FLINTLOCK DR, SHIRLEY, NY 11967-2616
(631) 687-9886
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
330081-1
NY
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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