Individual
AMELIA ELIZABETH WOOTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-2500
Mailing address
21 COUNTRY WAY, BETHEL, CT 06801-2935
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
030018
NY
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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