Healthcare Provider Details

I. General information

NPI: 1033773890
Provider Name (Legal Business Name): AMANDA J DOLIF APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 PARK AVE S STE 16389
NEW YORK NY
10003-0103
US

IV. Provider business mailing address

169 MADISON AVE STE 38114
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 646-876-8455
  • Fax:
Mailing address:
  • Phone: 646-876-8455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024198147
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11002252
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1246592
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN10049679
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberC-APN.0107300-C-NP
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209.036935
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: