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General NPI Number Information
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NPI Number | 1154966976
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Entity Type | Individual
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Provider Name | AMANDA ABDELDAYEM LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 85 SAINT JOSEPHS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1115
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Country | US
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Telephone | 718-226-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 230 MILL RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-4714
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Country | US
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Telephone | 347-701-0063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 09636801
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License Number State | NY
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