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1760800783 NPI number — AMANDA NICOLE STRADA

NPI Number: 1760800783
Health Care Provider/Practitioner: AMANDA NICOLE STRADA

Information about “1760800783” NPI (AMANDA NICOLE STRADA) exists in 1760800783 in HTML format HTML  |  1760800783 in plain Text format TXT  |  1760800783 in PDF (Portable Document Format) PDF  |  1760800783 in an XML format XML  formats.

NPI Number : 1760800783 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1760800783",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STRADA",
    "FirstName": "AMANDA",
    "MiddleName": "NICOLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "176 ASHWORTH AVENUE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "STATEN ISLAND",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10314-2950",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "609-865-3092",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "176 ASHWORTH AVENUE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "STATEN ISLAND",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10314-2950",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "609-865-3092",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/07/2014",
    "LastUpdateDate": "01/06/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": "833078141",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "2588671",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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