AMANDA DETIBERUS

MELVILLE, NY
NPI1164889598
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy174400000X Specialist
Enumeration Date2016-01-15
Last Update Date2016-01-15
Business Address
-- AMANDA DETIBERUS
538 BROADHOLLOW RD 202
MELVILLE, NY 11747-3676
Phone number: 631-385-7780
Mailing Address
-- AMANDA DETIBERUS
538 BROADHOLLOW RD 202
MELVILLE, NY 11747-3676
Phone number: