Individual
AMANDA JOAN COSTARELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1165 CASSEL AVE, BAY SHORE, NY 11706-6151
(516) 459-5383
Mailing address
1165 CASSEL AVE, BAY SHORE, NY 11706-6151
(516) 459-5383
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/06/2022
Last updated
08/06/2022
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