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NPI Code Detail

MEDICARE: AMANDA MARIE BITETTO

MEDICARE: AMANDA MARIE BITETTO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist067372NY

General Provider Information

NPI Number : 1205431277
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MARIE BITETTO
Provider Business Mailing Address
First Line : 753 FORT SALONGA RD
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-3148
Country : US
Telephone Number : 631-754-8374
Fax Number :
Provider Business Practice Location Address
First Line : 753 FORT SALONGA RD
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-3148
Country : US
Telephone Number : 631-754-8374
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2020
Last Update Date : 11/30/2020

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Directions to “ AMANDA MARIE BITETTO ” Practice Location

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