Individual
AMANDA HACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 DAFFODIL CT, STATEN ISLAND, NY 10312-1642
(646) 280-5111
Mailing address
18 DAFFODIL CT, STATEN ISLAND, NY 10312-1642
(646) 280-5111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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