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Individual

MRS. AMANDA BEHRENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
83 RIVERSIDE AVE, MASTIC BEACH, NY 11951-1120
(631) 729-6973
Mailing address
83 RIVERSIDE AVE, MASTIC BEACH, NY 11951-1120
(631) 729-6973

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
1232239181
NY
174400000X
Specialist
Primary
1232240181
NY

Other

Enumeration date
06/18/2018
Last updated
06/18/2018
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