Individual
AMANDA T L DELAROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
57 MISTY POND CIR, APT 7, MORICHES, NY 11955-1125
(631) 626-2541
Mailing address
57 MISTY POND CIR, APT 7, MORICHES, NY 11955-1125
(631) 626-2541
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
291888
NY
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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