Individual
AMANTAADONIS ADONIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11032 207TH ST, QUEENS VILLAGE, NY 11429-1706
(347) 742-8463
Mailing address
11032 207TH ST, QUEENS VILLAGE, NY 11429-1706
(347) 742-8463
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
3111821
NY
Other
Enumeration date
01/11/2014
Last updated
01/11/2014
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