Healthcare Provider Details

I. General information

NPI: 1639092869
Provider Name (Legal Business Name): AMANDA CAROLINE SEILS ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 LONG POND RD
ROCHESTER NY
14626-4164
US

IV. Provider business mailing address

320 LABURNAM CRES
ROCHESTER NY
14620-1826
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-7000
  • Fax:
Mailing address:
  • Phone: 315-577-2058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number433644
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: