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General NPI Number Information
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NPI Number | 1417773870
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Entity Type | Individual
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Provider Name | AMANDA LEIGH KEPFER NP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 300 E 66TH ST
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City | NEW YORK
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State | NY
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Zip | 10065-6800
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Country | US
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Telephone | 646-888-4662
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Fax | 646-888-4920
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Provider Business Mailing Address
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Address Line | 1700 BEDFORD AVE APT 17F
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City | BROOKLYN
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State | NY
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Zip | 11225-2606
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Country | US
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Telephone | 404-429-9919
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 312018
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License Number State | NY
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