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1871110692
NICOLE AMANDA WAXNER
ROSLYN, NY
NPI
1871110692
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 025121)
Enumeration Date
2020-06-27
Last Update Date
2020-06-27
Business Address
NICOLE AMANDA WAXNER
100 PORT WASHINGTON BLVD
ROSLYN, NY 11576-1347
Phone number: 516-562-6000
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Mailing Address
NICOLE AMANDA WAXNER
28 BRAMBLE LN
MELVILLE, NY 11747-2317
Phone number: 631-813-9031
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