Provider Demographics
NPI:1417461161
Name:AMANDA'S ANGELS LLC
Entity Type:Organization
Organization Name:AMANDA'S ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMSAMMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-283-5255
Mailing Address - Street 1:53 W MERRICK RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3709
Mailing Address - Country:US
Mailing Address - Phone:516-283-5255
Mailing Address - Fax:
Practice Address - Street 1:53 W MERRICK RD STE 2B
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3709
Practice Address - Country:US
Practice Address - Phone:516-283-5255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care