Individual
MRS. AUDREY A POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 MADISON ST, AMITYVILLE, NY 11701-1524
(631) 741-0327
Mailing address
102 MADISON ST, AMITYVILLE, NY 11701-1524
(631) 741-0327
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
259733
NY
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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