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NPI Code Detail

MEDICARE: AMANDA HARRIS MCCLELLAND MD

MEDICARE: AMANDA HARRIS MCCLELLAND MD
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
12084P0804XChild & Adolescent Psychiatry Physician276646NY
22084P0800XPsychiatry Physician276646NY

General Provider Information

NPI Number : 1073958674
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA HARRIS MCCLELLAND MD
Provider Business Mailing Address
First Line : 7559 263RD ST
Second Line :
City : GLEN OAKS
State : NY
Zip : 11004-1100
Country : US
Telephone Number : 718-470-5727
Fax Number :
Provider Business Practice Location Address
First Line : 7559 263RD ST
Second Line :
City : GLEN OAKS
State : NY
Zip : 11004-1100
Country : US
Telephone Number : 646-754-5034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2013
Last Update Date : 10/06/2023

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