Individual
AMANDA LAUREN BENINCASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
319 S MANNING BLVD STE 110B, ALBANY, NY 12208-1743
(518) 525-8220
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
016632
NY
363AS0400X
Surgical Physician Assistant
016632
NY
Other
Enumeration date
07/23/2013
Last updated
08/22/2023
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