Provider Demographics
NPI:1295359057
Name:ALMONTE, AMENDA
Entity Type:Individual
Prefix:
First Name:AMENDA
Middle Name:
Last Name:ALMONTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15804 SANFORD AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2532
Mailing Address - Country:US
Mailing Address - Phone:347-707-5136
Mailing Address - Fax:
Practice Address - Street 1:15804 SANFORD AVE APT 2A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2532
Practice Address - Country:US
Practice Address - Phone:347-707-5136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-07
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY773169163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical