Individual
MRS. AMANDA WHITE
Active
Individual
MRS. AMANDA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
010605
NY
363AM0700X
Medical Physician Assistant
Primary
25MP00395700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10605
NYS LICENSE NUMBER
NY
01
—
5347124
REGISTRATION CERTIFICATE
NY
Enumeration date
01/03/2007
Last updated
12/15/2020
Update your record
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