Individual
AMANDA LIBOREIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1236 RXR PLZ, UNIONDALE, NY 11556-1236
(516) 252-3939
Mailing address
150 PARK AVE, BETHPAGE, NY 11714-4406
(516) 426-7715
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022400
NY
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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