Individual
AMANDA RAINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
Mailing address
9 BASSWOOD LN, SMITHTOWN, NY 11787-4502
(631) 672-0673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
029575
NY
Other
Enumeration date
01/17/2023
Last updated
02/08/2023
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