Individual
AMANDA ELISE MIRCHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 572-0039
(631) 376-3798
Mailing address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 572-0039
(631) 376-3798
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
23015488
NY
Other
Enumeration date
03/29/2012
Last updated
07/21/2022
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