Healthcare Provider Details

I. General information

NPI: 1487857900
Provider Name (Legal Business Name): CHRISTINE JULIE AMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 PANORAMA TRL BUILDING 2; SUITE 180
ROCHESTER NY
14625-2404
US

IV. Provider business mailing address

625 PANORAMA TRL BUILDING 2; SUITE 180
ROCHESTER NY
14625-2404
US

V. Phone/Fax

Practice location:
  • Phone: 585-383-8840
  • Fax: 585-383-8843
Mailing address:
  • Phone: 585-383-8840
  • Fax: 585-383-8843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number015494
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: