Healthcare Provider Details

I. General information

NPI: 1033034756
Provider Name (Legal Business Name): AMANDA ORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 SCHOFIELD ST APT 2L
BRONX NY
10464-1549
US

IV. Provider business mailing address

190 SCHOFIELD ST APT 2L
BRONX NY
10464-1549
US

V. Phone/Fax

Practice location:
  • Phone: 914-874-6318
  • Fax:
Mailing address:
  • Phone: 914-874-6318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number770629
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: