Most Relevant Information
Provider Data
| NPI Number: | 1003303454 |
| Provider Name: | AMANDA MARIE DECAROLIS REGISTERED NURSE |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 624441-1 |
Most Important Dates
| Enumeration Date: | 04/20/2018 |
| Last Updated: | 04/20/2018 |
Provider Practice Location
1651 ONEIDA ST
UTICA
NY
135014866
Practice Location Phone/Fax
| Phone: | 3157937600 |
| Fax: |
Provider Mailing Location
2429 CHENANGO RD
UTICA
NY
135025908
Provider Mailing Phone/Fax
| Phone: | 3157937620 |
| Fax: |