Individual
AMANDA MAUREEN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
621 10TH ST, NIAGARA FALLS, NY 14301-1813
(716) 517-5436
Mailing address
814 LIGHTHOUSE PT, GRAND ISLAND, NY 14072-2267
(716) 517-5436
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
031114
NY
Other
Enumeration date
06/22/2024
Last updated
06/22/2024
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