Individual
AMANDA DIMAIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 MASTIC BEACH RD, MASTIC BEACH, NY 11951-1028
(631) 834-0972
Mailing address
240 MASTIC BEACH RD, MASTIC BEACH, NY 11951-1028
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
521302
NY
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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