Individual
AMANDA NICOLE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4898
(212) 606-1000
Mailing address
25 CHESTERFIELD DR, WARREN, NJ 07059-6774
(908) 655-8406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1176603
NJ
Other
Enumeration date
01/04/2021
Last updated
09/11/2023
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