Healthcare Provider Details
I. General information
NPI: 1124031265
Provider Name (Legal Business Name): FELICITAS G AMADOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
253 3RD AVE
NEW YORK NY
10010-7401
US
IV. Provider business mailing address
253 3RD AVE
NEW YORK NY
10010-7401
US
V. Phone/Fax
- Phone: 212-475-1900
- Fax: 212-475-0901
- Phone: 212-475-1900
- Fax: 212-475-0901
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Psychologist |
| License Number | XA5051610 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: