Individual provider · Type 1 NPI

Amanda Detiberus

Specialist · Melville, NY

NPI number 1164889598 Active

Practice location

538 Broadhollow Rd, 202
Melville, NY 11747-3676

Call (631) 385-7780 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1164889598

Amanda Detiberus's National Provider Identifier is 1164889598, issued on Jan 15, 2016. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Melville, NY. The record was last updated on Jan 15, 2016.