Individual
AMANDA MARIE BENACQUISTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2215 BURDETT AVE, TROY, NY 12180-2466
(518) 271-3300
Mailing address
44 MANSION BLVD APT J, DELMAR, NY 12054-2456
(518) 491-4920
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
678703
NY
363LF0000X
Family Nurse Practitioner
Primary
345607
NY
Other
Enumeration date
07/10/2020
Last updated
05/06/2021
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