Healthcare Provider Details

I. General information

NPI: 1669030474
Provider Name (Legal Business Name): NATASHA DEMI AMARO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE
HACKENSACK NJ
07601-1915
US

IV. Provider business mailing address

105 LEXINGTON CIR
MATAWAN NJ
07747-3777
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-1333
  • Fax: 551-996-0949
Mailing address:
  • Phone: 732-570-3515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number25MP00977700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: