Individual
AMANDA KOSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
68 PATCHOGUE AVE, PATCHOGUE, NY 11772-1693
(631) 339-1599
Mailing address
68 PATCHOGUE AVE, PATCHOGUE, NY 11772-1693
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
802064
NY
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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