MEDICARE: AMANDA SUN MS RDN CDN LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	012627	NY

General Provider Information

NPI Number	:	1043160138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA SUN MS RDN CDN LD

Provider Business Mailing Address
First Line	:	2315 44TH RD APT 9L
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-8509
Country	:	US
Telephone Number	:	917-318-1776
Fax Number	:

Provider Business Practice Location Address
First Line	:	2315 44TH RD APT 9L
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-8509
Country	:	US
Telephone Number	:	917-318-1776
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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