=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548137524
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERESA AMADI NP IN FAMILY HEALTH AND NP IN PSYCHIATRY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2025
-----------------------------------------------------
Last Update Date | 12/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 418 BROADWAY # 7882
-----------------------------------------------------
City | ALBANY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12207-2922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-991-2587
-----------------------------------------------------
Fax | 469-780-8758
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 474 AURA RD
-----------------------------------------------------
City | GLASSBORO
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08028-3206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-991-2587
-----------------------------------------------------
Fax | 469-780-8758
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | THERESA AMADI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 469-991-2587
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------