Individual
AMANDA IACOMETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-3000
Mailing address
18 WOODBURY RD, HAUPPAUGE, NY 11788-4730
(631) 786-9900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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