Individual
MR. DAVE AMARASENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
745 TYSENS LN, STATEN ISLAND, NY 10306-5621
(718) 667-3234
Mailing address
745 TYSENS LN, STATEN ISLAND, NY 10306-5621
(718) 667-3234
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F345844-01
NY
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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