Individual
AMANDA MARIE WIERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
PO BOX 263, PORT JEFFERSON STATION, NY 11776-0263
(631) 828-5419
(631) 403-1298
Mailing address
PO BOX 263, PORT JEFFERSON STATION, NY 11776-0263
(631) 260-1945
(631) 403-1298
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006495
NY
363AM0700X
Medical Physician Assistant
006495
NY
Other
Enumeration date
05/25/2012
Last updated
06/23/2025
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