Individual
AMALA VALLOMPURAYIDATHIL JOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 OLD ORANGEBURG RD, ORANGEBURG, NY 10962-1157
(845) 680-8546
Mailing address
44 VALLEY BROOK DR, EMERSON, NJ 07630-1027
(201) 289-2092
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
566597
NY
Other
Enumeration date
05/22/2024
Last updated
05/22/2024
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