Individual
AMANDA MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 JUNIPER AVE, RONKONKOMA, NY 11779-5926
(631) 704-1747
Mailing address
8 JUNIPER AVE, RONKONKOMA, NY 11779-5926
(631) 704-1747
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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