Healthcare Provider Details

I. General information

NPI: 1275045593
Provider Name (Legal Business Name): AMELIA RENEE HINKLEMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 PLAZA ST W
BROOKLYN NY
11217-3905
US

IV. Provider business mailing address

401 E 80TH ST APT 5D
NEW YORK NY
10075-0648
US

V. Phone/Fax

Practice location:
  • Phone: 718-789-4332
  • Fax:
Mailing address:
  • Phone: 419-789-9518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number308509
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: