Individual
MISS AMANDA JEAN ERARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
526 OLD LIVERPOOL RD, LIVERPOOL, NY 13088-6238
(315) 453-3911
Mailing address
PO BOX 10547, ALBANY, NY 12201-5547
(315) 451-9114
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
613538
NY
164W00000X
Licensed Practical Nurse
263307-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
05/02/2007
Last updated
12/14/2016
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