Basic Information
| Provider Information | |||||||||
| NPI: | 1831513621 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMAZAN | ||||||||
| FirstName: | JOSIANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 141 CLARIDGE AVE | ||||||||
| Address2: | |||||||||
| City: | ELMONT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110031510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9173880758 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22121 JAMAICA AVE | ||||||||
| Address2: | |||||||||
| City: | QUEENS VILLAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114282015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184686923 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2014 | ||||||||
| LastUpdateDate: | 02/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | 317346 | NY | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.