Healthcare Provider Details
I. General information
NPI: 1194344747
Provider Name (Legal Business Name): AMANDA MAJOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/14/2020
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
70 ATLANTIC AVE
BROOKLYN NY
11201-5501
US
IV. Provider business mailing address
146 PIERREPONT ST APT 3C
BROOKLYN NY
11201-2836
US
V. Phone/Fax
- Phone: 212-263-5506
- Fax:
- Phone: 214-957-8939
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 322743 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: